Published in Non-Clinical

How to Become an Aetna Provider

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2 min read

Here's how to become a provider with Aetna!

How to Become an Aetna Provider
Aetna is a managed health care company that provides a variety of medical insurance for employer-paid benefits programs and Medicare. As of 2018, they are owned by CVS Health. As an optometrist being an Aetna provider, you would be able to bill for medical eye exams for subsidiaries. If Aetna members have vision insurance, it is typically through Eyemed. To become an Eyemed provider, click here.

Step 1: Complete the introductory requirements

In order to become an Aetna vision provider, you must:
  1. Get your optometry license (see our guide that gives step-by-step instructions on how to get your optometry license in each state)
  2. Find a place to practice
  3. Get liability insurance—$1 million per claim.
  4. Obtain your NPI number.
  5. Begin the Medicare enrollment process (see our 41 Step Guide to Become a Medicare Provider w/ Screenshots).
  6. Register with CAQH.
See this in-depth guide for additional guidance on satisfying these core requirements. You’ll need to satisfy these requirements to become a provider with nearly every medical or vision plan.

Step 2: Complete plan specific requirements

  1. Fill out Online Request for Participation Form
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A. Fill out requested information
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B. For Specialty, select Optometry; Degree type: OD
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C. Fill in medical license number, CAQH, service location and mailing address
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D. Fill in your NPI information
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E. Fill in additional requested information
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F. Check “Agree” and click “submit”
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  • Aetna will evaluate need for providers in your area and contact you within 45 days to notify whether you can join their network.
  • Designate Aetna as an authorized health plan in your CAQH.
  • Once credentialing is complete, the contract will be finalized and you’ll receive welcome materials.

Disclaimer:

The author of the content you just read worked hard to provide you with this article. Even though we try our best, there is no guarantee that the article is error-free. CovalentCareers, its sponsors, advertisers, staff, and writers make no representation, warranty, or guarantee that this article and its contents are error-free and will bear no responsibility or liability for the results or consequences of the information contained within.

Kevin Cornwell, OD
About Kevin Cornwell, OD

Dr. Kevin Cornwell graduated from The New England College of Optometry in 2015. He went on to complete a residency in ocular and systemic disease with Indian Health Services in Zuni, New Mexico. He's had the unique opportunity to help open optometry departments within various community health centers around the country.

He now works with Health Care Partners of South Carolina and is enthusiastic about bringing eye care to populations in need. He has been involved with several humanitarian outreach projects, in various parts of California, New Mexico, Nicaragua and Mexico. He is passionate about managing the ocular manifestations of systemic disease, and monitoring ocular pathology. He’s also an avid health crusader and enjoys educating and encouraging patients to better manage their metabolic disease.

Dr. Cornwell also enjoys training for triathlons and recording music as a guitarist for the "Kevin Cornwell" YouTube channel.

Kevin Cornwell, OD
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