How do you become a provider with Aetna?


Quick Answer

Healthcare professionals that are looking to become providers within the Aetna network have to complete three steps: requesting and submitting an application, completing the credentialing process and undergoing a review of their applications and credentials. The credentialing process requires an evaluation of each healthcare professional's qualifications.

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Full Answer

There are three different application options that healthcare professionals can request. The applications are divided into applications for medical professionals, dental professionals and behavioral-health professionals. Applications can be requested online from the official Aetna website.

The application process looks at any certificates or licenses that the professional holds, her registration to practice, her academic background and training and an assessment of the applicant's professional conduct and competence. Aetna uses the Council for Affordable Quality Healthcare Universal Provider Datasource during the credentialing process. Applicants do have to designate Aetna as authorized to access their information on the application. Those that are not currently registered with the Council for Affordable Quality Healthcare can expect to receive a registration kit via mail once an application is made to Aetna.

Applicants who have questions regarding the credentialing process can contact Aetna directly via one of two numbers. Medical and Behavioral Health professionals can call 1-800-353-1232, while dental professionals can call 1-800-451-7715, as of May 2015.

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