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Aetna

Aetna Health Management, LLC — a CVS Health company. In Georgia and Texas the commercial and behavioural books sit under Aetna; individual lines are delegated to third-party vendors, and on a delegated line the vendor is the credentialing entity.

Commercial
Behavioral Health

Checked against this payer's own pages on 2026-11-04. Next review 2027-02-02.

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Every line of business, with what to watch for on each.
What we checked, and what we could not verify.
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What this page does not have

The checklist is the work

This page is the map: the channel, the order it happens in, the traps, what the payer publishes about time, and what we could not verify. It is not the checklist.

We do not publish the itemised list of documents and conditions for each line of business. You will not find it on this page, and you will not find it by reading. We hand it over instead: resolved for the line you are actually filing, and written down against your own file. It is the part that takes the work, and it is the part that goes wrong when nobody has done it.

The first step is $250: we read your documents against what Aetna asks for and tell you in writing what is missing, before anything is filed. It is credited in full against any engagement.

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Step one

Where you file

How you apply: Aetna's own participation request, processed by 3Won / ProVault
The path: aetna.com › Health Care Professionals › Join the Aetna Network › choose the BEHAVIORAL HEALTH application (not Medical) › the request is processed through 3Won / ProVault, where contracting and credentialing begin. CAQH registration kit within 10 business days of the request.
What access you need: A CAQH ProView profile with Aetna listed as an AUTHORIZED HEALTH PLAN. Aetna's credentialing data is pulled from ProView through a CVO accredited by URAC to NCQA standards.
Who verifies: Aetna uses CAQH ProView with a CVO accredited by URAC to NCQA standards
Worth knowing: Aetna runs FOUR separate join applications — Medical, Dental, Behavioral health, Pharmacy. A behavioural provider who files on the medical application is filing the wrong file. AFTER credentialing and contracting, Availity becomes the operational channel for claims, eligibility and authorizations.

Step two

CAQH

Required: Register, complete the profile, upload documents, attest, then authorise Aetna on the Authorization tab. The authorisation is the step that stalls files — without it Aetna cannot read the profile.
Authorise this payer: Aetna

Separate filings

Lines of business

Each line is its own application, with its own checklist, its own effective date and its own contract. Filing one does not file the others. What follows is what this payer asks for, line by line.

Commercial

Aetna's commercial book. The participation request is the SAME request for behavioural and commercial — the application TYPE on the join page decides which file you are in. Check the delegated-vendor question before filing: a commercial line can also be delegated.

Behavioral Health

Aetna's behavioural network. Aetna allows SUPERVISORY BILLING for licence-eligible behavioural clinicians (an APRN, for example): the supervisor must be independently licensed, credentialed and contracted with Aetna, employed by the same group or facility, and virtual supervision is allowed.

Before you file

What to watch for

The things that quietly stop a file, whichever line of business you are filing. We check each one before we file.

Must be trueThe line is NOT delegated to a vendor — Aetna is the credentialing entity for itAetna's own behavioural directory: providers marked with the vendor symbol 'may not be directly contracted with Aetna, and, consequently, not credentialed by Aetna.' On a delegated line the vendor is the entity you apply to, on the vendor's timeline. The test is the network name and behavioural health number on the member's ID card — Aetna's own delegated-vendor list page returned 404 on 2026-11-04, so we cannot hand a provider that link.
Must be trueFiled on the BEHAVIORAL HEALTH application, not the Medical applicationAetna runs four separate join applications — Medical, Dental, Behavioral health, Pharmacy. A behavioural provider on the medical application is filing the wrong file, and the request is processed by 3Won / ProVault regardless.
Must be trueAetna's panel is open in your service area and a Network Manager has contacted you to begin formal credentialingAetna reviews each request against whether it intends to add a provider in that geographic area. If the panel is closed the request is denied by letter or email — a BUSINESS DECISION, not a credentialing failure. Decision on the request: within 60 days.
Must be trueAetna is listed as an AUTHORIZED HEALTH PLAN in the CAQH Authorization tabAetna pulls its credentialing data from CAQH ProView. Without the authorisation the file stalls on arrival — this is not a missing document, it is a file nobody reads.
Must be trueIf billing under supervision: the supervisor is independently licensed, credentialed and contracted with Aetna, and employed by the same group or facilityAetna permits supervisory billing for licence-eligible behavioural clinicians. Virtual supervision is allowed. The supervisor's Aetna status is part of the clinician's file, not a separate piece of admin.
Must be trueCredentialing AND contracting both completeAetna is explicit that these are two separate processes and that both have to finish before the provider can see Aetna members. The written notice after credentialing is not an effective date.

Timing

What the payer publishes about time

These are the payer's own published figures. They are not our commitment, and they are not a promise about when you can bill.

Completeness review: The file is complete when the participation request is filed on the behavioural application and Aetna is authorised in CAQH. Aetna pulls the rest from ProView, so a stale or unattested profile fails every Aetna file at once.
Decision: Aetna publishes a decision on the participation request within 60 days. The panel gate comes before credentialing: if the panel is open a Network Manager contacts you to start formal credentialing, and if it is closed you get a denial letter or email.
Committee: notVerified — no committee cadence is published for Aetna behavioural
Contract: 30–60 days, countersigned through Adobe Sign (published).
What the numbers mean: The stage-by-stage figures — participation request 1–30 days, contracting 30–60, credentialing 60–90, countersignature and effective date 90–120 — come from the Spring 2025 Provider Education Bulletin. The current edition is Fall 2026 and the figures have NOT been re-verified. Where the later stages start their clock is not published either.

Clocks

Deadlines that start a clock

These run against a filing. Miss one and the filing stops, or restarts.

Aetna's published window for the CAQH registration kit (10 business days from the request)10 business days
counted from the date we submitted
Decision on the participation request60 calendar days
counted from the date we submitted
Credentialing stage should be complete90 calendar days
counted from the date we submitted
Written effective date120 calendar days
counted from the date we submitted

Recurring

Recredentialing

Cycle: notPublished
Worth knowing: No GA or TX behavioural recredentialing cycle is published in Aetna's own material that we could verify on 2026-11-04, so none is quoted. CAQH attestation (120 days) and the profile currency are the only recurring clocks we can state. Re-check on the next Aetna bulletin.

The date that matters

The effective date

Approval is not the date. These are the markers that make a date real.

How it is established: Aetna's systems reflect the participation effective date, and the directory updates only after countersignature. The published sequence ends at countersignature and effective date between 90 and 120 days.
What proves it: The written credentialing notice, the countersigned participating provider agreement, and a provider record and directory listing.
Contract date: This is not the same as the contract effective date. Track both.
Worth knowing: Do not record an effective date from the credentialing approval or from the participation request sitting in review. Credentialing and contracting are separate, both must complete, and the approval is not the date. We make NO backdate claim for Aetna: no published window was found.

Honesty

What we checked, and what we did not

Read this before relying on anything else on this page.

Verified 2026-11-04 against Aetna's own pages: the four application types and the behavioural application, the 3Won / ProVault participation path, the CAQH kit timing (10 business days) and the authorisation rule, the open/closed panel gate, the 60-day decision on the request, credentialing-is-not-contracting, Availity as the operational channel, the delegated-vendor marker language, the status and precertification phone lines, and the supervisory-billing rule. NOT verified: the committee cadence, the GA/TX behavioural recredentialing cycle, any backdating window, the delegated-vendor list (URL 404, no replacement verified), and the stage-by-stage timeline against the Fall 2026 bulletin.

Sources

The payer's own pages

Where to file

Join the Aetna Network — start the participation requestHealth Care Professionals › Join the Aetna Network › Behavioral healthChoose the BEHAVIORAL HEALTH application. Leaving the site routes the request through 3Won / ProVault. The behavioural application form that still resolves at provider/forms_secure/bh_form.html is a 2009-era mail-servlet form — do not send a provider to it.
CAQH / DataSpring — register and authorise AetnaProView › Authorization tab › add AetnaAetna sends the registration kit within 10 business days of the request form. Aetna must be an authorized health plan or the file stalls on arrival.
Availity — the operational channel once you are in the networkClaims, eligibility and authorizationsAvaility becomes the channel for claims, eligibility and precertification AFTER credentialing and contracting are complete.

Information and forms

Join the Aetna network FAQ — application types, CAQH, the panel gate, the 60-day decisionThe single most useful page for this payer: it states the four application types, the CAQH kit timing, the open/closed panel gate, the 60-day decision on the request, that credentialing is not contracting, and the status line.
Behavioral Health provider manual (PDF)Verified copy on Aetna's Spanish mirror. Covers the credentialing process, the precertification channels and the behavioural phone lines.
Aetna behavioral provider directory (DocFind)Carries the delegated-vendor marker language: 'The provider may not be directly contracted with Aetna, and, consequently, not credentialed by Aetna.' This is how a provider tells whether their line belongs to Aetna or to a vendor.
Provider Education Bulletin, Fall 2026 (PDF)Current edition. Source of the supervisory-billing rule for licence-eligible behavioural clinicians.
Provider Education Bulletin, Spring 2025 (PDF) — source of the staged timelineRE-VERIFY: the stage figures come from this edition. The current bulletin is the Fall 2026 one and we have not confirmed the figures are unchanged.
Electronic transaction vendorsAvaility, SSI (ClaimsNet) and other transaction vendors. This is NOT the delegated behavioural vendor list.
Behavioral health precertification list (PDF)The behavioural services that need precertification. Edition dated 1 Aug 2024 — check for a newer one before relying on it.

Who to contact

Aetna Credentialing Customer ServiceCredentialing status and escalation — medical AND behavioral health1-800-353-1232TTY 711. Have your NPI, TIN and submission reference number ready.
Aetna Provider Service Center — commercialBehavioral health precertification1-888-632-3862TTY 711. Medicare is 1-800-624-0756. Availity and AetnaElectronicPrecert.com are the other two channels.
Aetna Behavioral HealthBehavioural network1-800-926-2273
Network ManagerNamed contact once Aetna opens a panel and begins formal credentialingAssigned by Aetna. Not published — ask Aetna to assign one.

These are the payer's own pages. If a link stops working, tell us and we will re-check it. Links we could not verify are not published here.

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