How Do Health Care Providers Apply to Be Apart of the Aetna Network?

Health care providers apply to be part of the Aetna network by going to the Health Care Professionals section on Aetna’s website, according to Aetna. From there they can choose one of the links under How to Apply, which includes medical professionals, dental professionals and behavioral health professionals.

The three sections each have a form designed for relevant health care providers that providers must fill and submit, and within 10 days, they receive an application request acknowledgement, explains Aetna. On the form, a health care provider must provide information, such as name and address, population he works with, and his provider practice focus.

A health care provider must go through Aetna’s evaluation process for qualification, states Aetna. Aetna assesses his certificates and licenses, registration to practice, academic background and training, and professional conduct and competence. Aetna uses Council for the Affordable Quality Healthcare, Universal Provider Datasource to determine a health care provider’s credibility. Health care providers who apply to be part of Aetna’s network but have not registered with CAQH receive a registration kit via mail within 10 to 14 days.

Health care providers in the Aetna network are under contract to provide health care at lower rates to Aetna’s clients, says Aetna. Patients pay copayments or coinsurance in addition to their deductibles. Aetna includes network health care providers in the online directory where clients can log in and find them.