CVS Health® provides the info on the next page. Aetna® is part of the CVS Health family of companies. If you want to stay on our site, choose the “X” in the upper right corner to close this message. Or choose “Go on” to move forward to CVS.com.
Questions?
You can learn more about our network. Just call Provider Relations at 1-866-638-1232 (TTY: 711). We’re here for you Monday through Friday, 8 AM to 5 PM.
Why our network?
Why our network?
Whether you’re a physical or behavioral health care provider, we’ll work with you to understand your business and meet your needs.
When you take part in our provider network, you benefit from:
- Competitive compensation
- Timely and efficient claims processing
- Access to advanced technology to help enhance patient care
- Healthcare Effectiveness Data and Information Set (HEDIS®) performance incentives
- Ongoing professional support and training from our experienced team
Get all the answers you need from our communication materials, including the provider manual, newsletters and bulletins, emails, website notices, training kits and more.
We also help you:
- Track member information and updates
- Find forms
- Review claims or remittance advice
- Update changes to your practice
Your Provider Relations team
Your Provider Relations team
After you join our network, we’ll assign you a Provider Relations representative. They’ll be your primary point of contact with us, sharing important information with you. They’ll also help you with any admin or operational concerns, like tracking member information and updates, finding forms and reviewing claims or remittance advice.
Your Provider Relations representative will:
- Share our administrative policies and procedures
- Communicate changes and updates that help you in the efficient administration of our plans
- Advocate on your behalf to resolve issues
- Manage changes to your demographic information
Our Provider Relations representatives are based in the communities they serve, fostering personal relationships and a high level of responsiveness. They engage with providers in a variety of ways to provide proactive, prompt and collaborative communication.
You can also find answers in your provider materials, like your provider manual (PDF), notices and newsletters, training, emails and more.
Provider Relations representative territory map (PDF)
How to join our network
You have a few options for applying to join our network. You can apply:
Online
Complete the prospective provider online form.
By email
Download and complete the Out of Network Request to Join form (PDF). Then, email it to us.
By fax
Download and complete the Out of Network Request to Join form (PDF). Then, fax it to 1-877-533-5887.
What happens next?
We’ll send you a letter (within 60 business days) accepting or declining a contract.
If the panel is open and we decide to pursue a contract, a Provider Relations representative will contact you to proceed with the formal credentialing and contracting process.
If the panel is not open or we don’t decide to pursue a contract, we’ll send you a letter to let you know that we denied your request.
Is your practice already contracted with Aetna Better Health? If yes, you can apply to have new providers added to your existing group contract.
You have a few options for how to apply.
(Note: If you are submitting applications for 10 or more providers, you’ll need to apply using the Bulk Applications Provider Enrollment Template. Continue scrolling down to learn more.)
By email
Download and complete the Practitioner application form (PDF). Then, email it to us.
By fax
Download and complete the Practitioner application form (PDF). Then, fax it to 1-860-754-5435.
Are you submitting applications for 10 or more providers?
If yes, you’ll need to download and complete the Bulk Applications Provider Enrollment Template spreadsheet. (Note: clicking this link will automatically download a spreadsheet to your desktop.) You can also get this spreadsheet by calling Provider Relations.
How to submit your spreadsheet
- Make sure to complete all fields in your spreadsheet. Missing required data fields can cause the file to be rejected and the provider credentialing process to be delayed.
- Save it to your desktop. Rename the file as “PROVIDER GROUPNAME_DDMMYYYY” (replace fields with your group name along with date, month and year).
- Email it to us and be sure to copy your Provider Relations representative.
What happens next?
We’ll send you an email (within 10 days) letting you know that we received your spreadsheet. Full credentialing is completed within 60 days of receipt of a complete application.
Questions? Just email us. Or call 1-866-638-1232 (TTY: 711).
Our provider network includes hospitals, physicians, specialists, surgery centers, ancillary providers and centers of excellence throughout the United States.
To qualify, providers must meet all of these criteria:
- Hold a current, valid Pennsylvania state license to practice medicine
- Have staff privileges at a participating Pennsylvania hospital
- Have an active DEA certificate
- Provide verification of medical school completion, residency training and fellowship
- Have current professional liability insurance that meets state minimum requirements
- Hold a valid PROMISE ID at each service location before treating any of our members
Some timelines to note:
- Within 10 calendar days of completing the Practitioner Application Screening Form: We’ll send you a letter saying that we received your form. Those that pass our pre-screening verification will be entered into the credentialing process.
- At or before 30 days in the process: A second correspondence notification is sent out.
- Up to 60 calendar days: This is the amount of time it may take to be credentialed and approved, at which point you’ll receive an acceptance letter.
We’ll let you know your effective date of participation after complete credentialing and full execution of your contract. Be sure to wait for this date before you start seeing our members. If it’s a new contract, you’ll receive the fully executed contract.
Notices will be sent to applicants not approved to join the Aetna Better Health network.
Questions? Just email us. Or call 1-866-638-1232 (TTY: 711).