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:
- Get your optometry license (see our guide that gives step-by-step instructions on how to get your optometry license in each state)
- Find a place to practice
- Get liability insurance—$1 million per claim.
- Obtain your NPI number.
- Begin the Medicare enrollment process (see our 41 Step Guide to Become a Medicare Provider w/ Screenshots).
- 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
- Fill out Online Request for Participation Form
A. Fill out requested information
B. For Specialty, select Optometry; Degree type: OD
C. Fill in medical license number, CAQH, service location and mailing address
D. Fill in your NPI information
E. Fill in additional requested information
F. Check “Agree” and click “submit”
- 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.
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Step-by-step credentialing guides
The credentialing process for different insurance plans varies quite a bit. Some plans are relatively simple and others require much more work. The below guides walk you through the process for the most common vision and medical insurance plans.