Wiki Aetna Credentialing/Contracting

[Eroy028]

I work as the credentialing specialist for an ABA therapy group and experience the worst time with Aetna and their processes. Does anyone happen to know of anything helpful in moving along their process of credentialing, on boarding and demographic loading? I submit applications to Aetna and many of them take close to a year if not longer in order to finally receive an in network status for billing. Does anyone else experience this problem with them?
According to them their process is supposed to be 30-45 business days for credentialing, 60-90 business days for on boarding, and then 30-45 business days for in network demographic loading. Is this information along the same lines that anyone else has been given for behavioral health with Aetna? I primarily work in the states of Texas, Colorado, and Oklahoma.

Thank you.

 

[shreemannari123]

I don't work as credentialing specialist but work as a billing specialist. Sorry @Eroy028 for I am not of much help with your question, but getting through Aetna claims line to ask about reason for their denials/rejections has been an issue. They don't seem to have any live representatives who can help us. The automated system keeps repeating itself and asks us to check Availity. Unfortunately, Availity is of not much help when it comes to claims being rejected without any reason code. Anybody has experienced this? Aetna is really giving us hard time.
Appreciate any input.
Thank you,

 

[jshirley10]

I have been waiting over 60 days since submitting our application to Aetna (behavioral health) and have yet to receive a response to my request for an update through Availity's payer spaces. I have heard so many nightmare stories about Aetna!!

 

[kdsrodriguez]

I have credentialed 3 providers over the past year with Aetna and it was a headache. On average it took about 120 days start to finish and that was with an LCPC, PMHNP and a psychiatrist. There is no way to get updates and you can only call once every 2 weeks to get an update. I always start them as soon as the ink is dry on their contract knowing they will be the last one to finalize anything.

 

[lisaray]

I have credentialed 3 providers over the past year with Aetna and it was a headache. On average it took about 120 days start to finish and that was with an LCPC, PMHNP and a psychiatrist. There is no way to get updates and you can only call once every 2 weeks to get an update. I always start them as soon as the ink is dry on their contract knowing they will be the last one to finalize anything.

I agree Aetna is lacking with their provider relations with regard to contracting credentialing.. I have one provider that I have called for minimum of 25 times about getting an address taken out for Aetna Medicare pt's and they still haven't done it. She is enrolled for EFT and they mail checks to an address from 5 years ago.intermittently Not for every claim. It is crazy. I update in Availity and when i call they assure me that the issue is fixed. Yet sporadically they still continue to mail checks to the old address. There is no coordination and no appointed Provider Rep to contact via email or phone. I don't understand how they get away with it