Aetna Provider Credentialing & Enrollment

Quick Answer

Choose Aetna’s request-for-participation category, submit the request, and authorize Aetna to retrieve your CAQH profile when requested. A participation request, credentialing verification, and an effective network agreement are separate milestones.

Verified Requirements

Select the request form for medical or behavioral health, dental, facility or ancillary, or pharmacy. Aetna distinguishes a physician group’s individual application path from the facility’s Type 2 NPI request. See Aetna’s network participation instructions.
Review the license, liability coverage and practice locations in CAQH, and authorize Aetna to access the profile when your pathway uses CAQH.

What Varies

Aetna assesses network need by market. Aetna Better Health Medicaid participation can use state plan instructions. See Aetna’s provider forms and Medicaid instructions.

Common Enrollment Problems

Verify that the category and NPI identify the applicant correctly. Check the CAQH authorization and retain the participation request confirmation.

What ProEnrollment Handles

We can review CAQH readiness, match providers to the correct request type and track contracting and effective dates separately.

Managed Aetna enrollment · CAQH profile management

Next Step

Request a credentialing consultation for help choosing the right Aetna application or following up on a pending request.