How to Get Credentialed with Aetna for Mental Health Providers

Many providers wonder how to get credentialed with Aetna for mental health services and in this guide we'll teach you how to submit your application, what's required, as well as a time-frame for processing.

Aetna is one of the largest insurance brands in the United States and it’s no wonder providers are inquiring about how to get credentialed with Aetna for mental health services.  The process is simple!  We’ll show you how.how to get credentialied with aetna for mental health providers

Where to Apply to Aetna for Mental Health Providers

Credentialing with Aetna is completed online.  Different service types have differing applications to submit.  For behavioral health providers, submit your application at:  https://www.aetna.com/health-care-professionals/forms/behavioral-health-application.html

What is Required to Get Credentialed with Aetna

  1. You must be a licensed mental health provider
  2. You must have a complete CAQH profile
  3. Your own service location that can receive mail

Does this sound like something you’d just rather not handle?  Inquire about our credentialing services for mental health providers to have us take this off your plate.

How Do I Register with CAQH?

You can register online at:  https://proview.caqh.org/PR/Registration

What Aspects of Your Background Influence Your Application

  • Licensure and/or certification verified through state licensing boards in geographical areas where network practitioners will care for our members
  • Board certifications (when applicable)
  • Loss of/limitation of hospital admitting privileges (when applicable)
  • Current professional liability coverage
  • Drug Enforcement Agency (DEA) and state controlled-drug substance registration, when applicable, through verification by the U.S. Department of Commerce National Technical Information Service (when applicable)
  • Disciplinary history or adverse actions related to licensure and DEA registration, which we query through state licensing boards and the National Practitioner Databank (NPDB)
  • Malpractice insurance claim history to examine any possible trends and to look for
    evidence that might suggest any probable substandard professional performance in the
    future
  • Mental and physical health to determine if the practitioner’s history might suggest any probable substandard professional performance in the future
  • Participation in government programs such as Medicare or Medicaid
  • Professional education and training through verification by the American Medical Association (AMA) Masterfile, American Osteopathic Association (AOA) and specialty board or specific residency/training program (highest level of education, depending on practitioner type)
  • Work history

Source: http://www.aetna.com/pharmacy-insurance/healthcare-professional/documents/credentialing-overview.pdf

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