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Join our network

We are excited that you are interested in joining Aetna's powerful network of physicians and health care professionals committed to driving people's path to better health.

Have a question?

You can email Network Relations. Or call 
1-855-454-0061 (TTY: 711).

Do you want to join the Aetna Better Health® of Kentucky network?

Do you want to join the Aetna Better Health® of Kentucky network?

Here is how it works:

 

Step 1

To join our network, you must first be enrolled in Kentucky Medicaid. To enroll in Kentucky Medicaid, please go to the Medicaid Provider Portal Application (MPPA). 

 

Step 2

Providers who are not participating need to request a contract by completing the provider nomination form. Once completed please return to KYProviderUpdates@Aetna.com.

 

Step 3

Once the nomination form is received and reviewed, someone from the contracting team will send you a contract and credentialing packet. Please complete and return the both via the instructions.

 

Step 4

While the contract is being reviewed, the credentialing information is forwarded to our Credentialing Verification Organization (CVO) Verisys, formerly known as Aperture Health. Verisys is responsible for direct credentialing for our network of providers.

 

**Independent Physician Practice Associations (IPA) and Hospital Organizations that currently have a delegated credentialing agreement are excluded from this process. For complete information about the credentialing process and other requirements for participation, you can download our provider manual (PDF)

 

Step 5

Once credentialing is completed, your contract will be finalized, and you will receive your welcome materials from your assigned Network Manager.

 

If you need more information about our application and credentialing process, email KYProviderUpdates@Aetna.com or see Credentialing links below.

Why our network?

Why our network?

We’ll work with you to understand your business and meet your needs — no matter what services you offer or where you offer them. When you take part in our strong provider network, you benefit from: 

 

  • Competitive compensation 

  • Ongoing support and learning opportunities  

  • Timely and efficient claims processing

  • Advanced technology to help enhance patient care

Your Network Relations team

Your Network Relations team

After you join our network, we’ll assign your facility a Network Relations Representative. They’ll be your primary point of contact with our plan, sharing important information with you. They’ll also help you with any administrative or operational concerns.

   

Your Network Relations team manages the network. And they’ll work to: 

 

  • Share our administrative policies and procedures   

  • Communicate changes and updates that help you in the efficient administration of our plans

  • Advocate on your behalf to resolve issues  

  • Manage changes to your demographic information

Aetna Better Health will bypass for Commercial Primary the following code sets: H codes, T codes and EPSDT codes. An EOB is not required to process these claims. Medicare primary claims will follow the DMS published bypass list.

 

Medicaid commercial bypass list (PDF)

 

Commercial insurance coverage provider attestation form (PDF)

 

Aetna Better Health of Kentucky coverage rates (PDF)

 

KY Department of Medicaid Services fee schedule

 

Aetna Better Health of Kentucky CMHC fee schedule (PDF)

 

Aetna Better Health of Kentucky surgical grouper crosswalk (PDF)

Aetna Better Health of KY participates in the Kentucky Health Alliance to provide credentialing services.  For this venture, KHA subcontracted with Verisys for completion of Primary Source Verification. Independent Physician Practice Associations (IPA) and Hospital Organizations that currently have a delegated credentialing agreement are excluded from this process. For complete information about the credentialing process and other requirements for participation, you can download our provider manual (PDF). Here are some more links that will help you apply for credentialing. Completed forms should be sent to KYProviderUpdates@aetna.com.

 

Practitioner instructions/application (PDF)

 

Facility application for participation (PDF)

 

Provider change/update form (PDF)

 

Hospital based providers (PDF)

The KHIE is a secure, interoperable network in which participating providers with certified electronic health records technology (CEHRT) can share needed patient health information with other providers at the point of care. As part of our commitment, we are working with the newly designed KHIE platform to develop a transformative solution to optimize care coordination and service delivery and to achieve quality outcomes.

 

Providers who contract with us are encouraged to sign a participation agreement with KHIE. This will also help providers fulfill meaningful use requirements in order to qualify for Medicaid’s EHR Incentive Payment Program, since providers must have a signed participation agreement and signed addendums on file with KHIE for each public health objective selected for attestation.

 

Intended for all facilities, Aetna Better Health also recommends the submission of ADTs (Admission, Discharge, Transfer messages) to KHIE.

 

For providers who do not have electronic health records, Aetna Better Health recommends that those providers (offices) sign a Participation Agreement with KHIE. Aetna Better Health also recommends signing up for Direct Secure Messaging services so that the clinical information can be shared securely with other providers in their community of care.

 

Learn more about KHIE

Aetna Better Health of Kentucky uses InterQual to ensure consistency in utilization practices. The guidelines span the continuum of patient care and describe best practices for treating common conditions. The InterQual guidelines are updated regularly.

 

Learn more about InterQual

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