Jogaza Credentialing

Aetna credentialing: joining the network and changing your tax ID

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Short answer

  • New to Aetna: apply through aetna.com, Join Our Network, Request for Participation.
  • Already contracted, new tax ID: it's a change to your existing contract, not a new application. If you have Availity, send it through Availity > Payer Spaces > Aetna > Contact Us.
  • Put both tax IDs (old and new) in the request. Aetna's first reply to us asked for the TIN before it would research anything.

Joining Aetna

  1. On aetna.com, open Medical Providers and choose Join Our Network.
  2. On the Request for Participation screen, choose "I am interested in applying for medical or behavioral health".
  3. Choose the option that describes you, for example an individual provider applying under a tax ID that isn't participating with Aetna yet.
  4. Aetna pulls your details from CAQH ProView, so make sure your profile is current, attested and authorizes Aetna first (CAQH guide).

Changing your tax ID on an existing contract

This is the one that trips people up. A solo psychiatric nurse practitioner practice in the Richmond area had an Aetna group agreement under an old tax ID and got a new EIN for the LLC. Here's what we learned:

  • With Availity access: Aetna's credentialing line says tax ID, name, address and phone changes must go through Availity > Payer Spaces > Aetna > Contact Us. Choose the reason "The status of an update/correction to your provider data". The message box allows 500 characters and no attachments, so be brief.
  • Without Availity: send a written request on letterhead with your W-9 by fax to Aetna Provider Data Services, (859) 455-8650.
  • Availity says Aetna's Provider Service Center will contact you within 48 hours by phone or email. Their first reply came from an unmonitored mailbox asking for the TIN, so include both tax IDs and the group NPI from the start.

Phone numbers

  • Provider Service Center: 1-888-632-3862. Staff here may transfer tax ID questions to credentialing.
  • Credentialing customer service: 1-800-353-1232. Automated. For demographic and tax ID changes it points you back to Availity or the fax; we never reached a person for this.

Avoid a cancelled change

Aetna cancelled an earlier tax ID change because the name on the new EIN didn't match the name on the contract. Before you submit, check that the legal name on your IRS EIN letter (CP 575) and your W-9 match the contract's name, character for character.

Aetna's Medicaid plan, Aetna Better Health of Virginia, is a separate contract with its own process. See Virginia Medicaid credentialing.

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