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  • Aetna Initial Provider Application Form 2017

Get Aetna Initial Provider Application Form 2017-2025

Initial Provider Application Please include all forms and attachments upon return. Provider Information - Please check the box if additional information is attached Name - Last First Middle (Jr.,.

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Documents typically take 2-5 days for CAQH's approval. Required documents must be successfully uploaded and approved by CAQH before the CAQH ProView profile is considered complete and accessible to HSCSN. Providers are notified when a health plan is requesting access to their profile and when viewing their profile.

Receive the status of their credentialing or recredentialing application, upon request. Providers may contact 1.800. 88Cigna (1.800. 882.4462) to inquire about the status.

You may submit retrospective review requests for services requiring authorization on members that are retro actively eligible to 1-844-227-9205.

For most states, we use CAQH to obtain your credentialing application. Make sure all data is up to date. Once you have been approved in the credentialing process, Aetna will countersign and return your final contract via email through AdobeSign.

To initiate a request, submit electronically on Availity or call our Precertification Department. Submit your medical records to support the request with your electronic submission. We've made it easy for you to authorize services and submit any requested clinical information.

Currently, 2.5 million healthcare providers, >100K dentists and 1,000 health plans, hospitals and other healthcare organizations participate with CAQH solutions to simplify credentialing.

For some services, your PCP is required to obtain prior authorization from Aetna Medicare. You'll need to get a referral from your PCP for covered, non‐emergency specialty or hospital care, except in an emergency and for certain direct‐access service. There are exceptions for certain direct access services.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232