Aetna®: New Credentialing Requirement for Individual Nurse Practitioners

02/10/2025

Aetna®: New Credentialing Requirement for Individual Nurse Practitioners 

 

As of Oct. 15, Aetna® implemented a new credentialing requirement for all Individual Nurse Practitioners (NPs), with the exception of those who are hospital-based or delegated.  

What Does This Mean for Nurse Practitioners? 

Aetna's new policy introduces distinct pathways for newly onboarded and existing NPs. Here’s what you need to know: 

1. New Individual Nurse Practitioners 

  • All newly practicing NPs must undergo Aetna’s provider onboarding process. 
  • A complete Council for Affordable Quality Healthcare (CAQH) application is a prerequisite to initiate credentialing. 
  • The onboarding process ensures that new providers meet Aetna’s quality standards before delivering care to patients. 

2. Existing Non-Credentialed Nurse Practitioners 

  • For NPs currently serving Aetna members but not yet credentialed, Aetna will gradually introduce them into a credentialing cycle over the coming months. 
  • To streamline the process, practitioners are encouraged to verify and complete their CAQH applications. A complete application will significantly reduce delays in credentialing. 

What You Need to Do 

To comply with this new requirement, Individual Nurse Practitioners should take the following steps: 

  1. Verify Your CAQH Application 
  2. Ensure your CAQH profile is complete, accurate, and up-to-date. 
  3. Include all required documentation, such as licenses, certifications, and insurance information. 
  4. Monitor Communications from Aetna 
  5. Look out for notifications or instructions regarding your credentialing timeline. 
  6. Respond promptly to any requests for additional information to avoid delays. 
  7. Prepare for Onboarding 
  8. If you are a new NP, familiarize yourself with Aetna’s onboarding requirements and start the credentialing process as soon as possible. 

Support and Resources 

Aetna provides resources to assist NPs in navigating this change: 

  • Access the Aetna Provider Portal for updates and further guidance on credentialing requirements. 
  • Utilize the CAQH Help Center to ensure your application meets Aetna’s criteria. 
  • Contact Aetna’s provider support team with any specific concerns or questions. 

Act now to stay ahead of the changes and ensure your credentialing process proceeds smoothly. 

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