Payer-Specific Service

Aetna Credentialing & Enrollment

Specialized credentialing and enrollment services for Aetna commercial, Medicare Advantage, and Medicaid plans. Get in-network with Aetna, a CVS Health company, and access millions of covered members nationwide.

850+ Aetna Providers

45-60 Days Average

97% Approval Rate

Start Aetna Enrollment Free Aetna Consultation

CVS Health Company

Complete Aetna Enrollment

Commercial, Medicare Advantage, and Medicaid plan credentialing

Our Process

Aetna Credentialing Made Efficient

Our streamlined 3-step process ensures your Aetna enrollment is completed accurately and quickly.

CAQH & Availity Setup

We ensure your CAQH ProView profile is complete and attested, and set up your Availity provider portal access for Aetna.

Aetna Application Submission

We prepare and submit complete credentialing applications through Aetna's provider enrollment portal with all required documentation.

Follow-Up & Contracting

We track application status, respond to Aetna requests, and assist with contract review and signature upon approval.

Aetna Plans We Cover

All Aetna Plan Types

We credential providers for all Aetna commercial, Medicare, and Medicaid products.

Aetna Commercial

PPO, HMO, EPO, POS, and Open Access plans

Aetna Medicare Advantage

HMO, PPO, and Dual Eligible Special Needs Plans

Aetna Better Health

Medicaid managed care programs

Aetna Exchange Plans

ACA Marketplace individual and family plans

Aetna Self-Funded

ASO and Administrative Services Only plans

Aetna International

Global coverage for expatriates and travelers

Aetna Student Health

College and university health plans

Aetna Meritain Health

Third-party administrator health plans

CVS Health Network

Aetna + CVS Health Integration

Understanding Aetna's unique position as part of CVS Health and what it means for credentialing.

MinuteClinic Credentialing

Referral relationships with CVS MinuteClinic locations

CVS Pharmacy Integration

Understanding of CVS Caremark prescription networks

HealthHUB Locations

Credentialing for CVS HealthHUB expanded services

Aetna Virtual Care

Telehealth credentialing for virtual primary care

Core Requirements

Aetna Credentialing Essentials

We ensure all Aetna credentialing requirements are met with precision.

CAQH Attestation

Current CAQH profile with recent attestation (within 120 days)

State Medical License

Active, unrestricted license in practicing state

DEA Registration

Valid DEA certificate for controlled substances

Board Certification

ABMS or AOA board certification status

Malpractice Insurance

Minimum coverage per Aetna requirements

Work History

Complete 5-year work history with gap explanations

W-9 Form

Current IRS W-9 for tax identification

Background Screening

OIG, SAM, and NPDB clearances

Why Choose Us

Aetna Credentialing Excellence

We understand Aetna's specific credentialing requirements and processes.

Availity Portal Expertise

Deep familiarity with Availity, Aetna's primary provider portal for credentialing and claims management.

Error-Free Applications

We ensure applications meet all Aetna-specific requirements to prevent processing delays.

Aetna Better Health Expertise

Specialized knowledge of Aetna's Medicaid managed care credentialing requirements.

Recredentialing Support

Ongoing monitoring and management of Aetna's 3-year recredentialing cycle.

FAQ

Aetna Credentialing Questions Answered

Clear answers to common questions about Aetna credentialing.

How long does Aetna credentialing take?

Aetna credentialing typically takes 45-90 days from application submission to effective date. Our expedited process helps minimize delays.

Does Aetna require CAQH?

Yes, Aetna requires providers to maintain a current, attested CAQH ProView profile. Re-attestation is required every 120 days.

What is Availity and do I need it for Aetna?

Availity is Aetna's primary provider portal for credentialing, claims submission, and eligibility verification. We help set up and manage your Availity account.

Does Aetna credential non-physician providers?

Yes, Aetna credentials Nurse Practitioners, Physician Assistants, and other advanced practice providers. Requirements vary by state and specialty.

What is Aetna's recredentialing cycle?

Aetna requires recredentialing every 3 years. We track your cycle and manage the complete recredentialing process.

Does Aetna require site visits?

Site visits may be required for certain specialties or high-volume practices. We help prepare you for any required inspections.

Can I join Aetna Medicare Advantage separately?

Yes, Aetna Medicare Advantage requires separate credentialing from commercial plans. We manage both processes simultaneously.

What is Aetna Better Health?

Aetna Better Health is Aetna's Medicaid managed care program. Credentialing requirements differ from commercial and Medicare plans.

How does CVS Health ownership affect credentialing?

Aetna's integration with CVS Health has expanded network opportunities including MinuteClinic and HealthHUB referrals. We understand these new pathways.

What is Meritain Health?

Meritain Health is Aetna's third-party administrator for self-funded employer plans. Credentialing may have different requirements.

Ready to Join Aetna's Network?

Let our Aetna credentialing experts get you in-network quickly and start seeing millions of Aetna and CVS Health members.

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