How to Get Credentialed with Aetna in Montana
Aetna in Montana: by the numbers
Verified figures for this state, not national averages.
- Counties containing at least one member
- 54
- Distinct plans
- 12
- Largest counties by enrollment
- Yellowstone (2,776), Missoula (2,277), Flathead (2,095), Gallatin (1,571), Ravalli (1,325)
- Medicare Advantage members in state
- 21,178
Source: CMS Monthly Enrollment by Contract/Plan/State/County (2026-07) · Verified July 2026
Quick Overview
Timeline
90 - 150 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
Yes
How Aetna Credentialing Actually Works
Verified July 2026Apply Through
Aetna request for participation (via ProVault)
Timeline
Aetna commits to a network eligibility answer within 45 days (60 for facilities). No credentialing day count is published beyond that.
Recredentialing
Every 36 months
Aetna is contract first: submit the online request for participation, Aetna decides network eligibility, and only then pulls your credentialing application from CAQH ProView (Arkansas uses ARCCVS instead). Authorize Aetna on CAQH before you start or the pull fails.
Behavioral health routing: Behavioral health is run in house as an internal business unit of Aetna, with its own dedicated behavioral request for participation form, separate from the medical, dental, and facility flows.
The stall to avoid: The 45 day network need decision can end the process before credentialing ever starts. If you are declined, document the access gap you fill: specialty, language, geography, lines of business. Credentialing status line: (800) 353-1232.
From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.
Montana-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for Montana.
Complete Your CAQH ProView Profile
Aetna requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to Aetna. You can start the process at their enrollment portal.
Track & Follow Up
Credentialing typically takes 90-150 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
Need help enrolling with Aetna?
Our specialists handle the entire Aetna enrollment process: applications, follow-ups, and approvals in Montana.
Required Documents Checklist
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
5-year work history minimum; gaps > 6 months must be explained
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Photo
Provider headshot photo for directory
Professional Reference
3 peer references required
W9_FORM
Required for EFT/tax reporting setup
Enrollment Forms
CAQH ProView
Universal credentialing application used by most commercial and BCBS payers.
RequiredCAQH ProView
Universal credentialing application used by most commercial and BCBS payers.
RequiredRequest to Join Network
RequiredAetna ProVault Application
RequiredFree Tools for Your Aetna Enrollment
Related Articles
Can You Bill Retroactively After Credentialing? Medicare, Medicaid, and Commercial Payer Rules Explained
Can you bill retroactively? Medicare: 30 days back. Medicaid: varies by state. Most commercial payers: no. Payer-by-paye...
10 Credentialing Mistakes That Are Costing Your Practice $122K+ (And How to Fix Them)
85% of credentialing applications contain errors. These 10 mistakes cost providers $122K+ in delayed revenue. Real-world...
Which Insurance Panels Should You Join First? A Data-Driven Prioritization Guide for New Practices
Do not credential with 12 payers at once. Prioritize by market share, reimbursement rate, and processing speed. Specialt...
Key Credentialing Terms
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- Primary Source Verification
- The process of verifying a provider's credentials directly from the original issuing source, such as medical schools, li...
- Provider Enrollment
- The process by which a healthcare provider applies to participate in an insurance payer's network, allowing the provider...
- Re-credentialing
- The periodic process, typically occurring every three years, in which a provider's credentials are re-verified to ensure...
Credentialing Checklist
Make sure you have everything ready before applying to Aetna.
View Physician Credentialing Checklist →Contact Information
Credentialing Status/Questions
National1-800-353-1232
Provider Relations
National1-800-441-5501
Mon-Fri 8am-7pm
ERA/EFT (Optum OPES)
National1-800-353-1232
Claims Inquiry
National1-800-624-0756
Provider Appeals
National1-800-353-1232
Fax: 1-866-445-4387
Behavioral Health Credentialing
National1-888-632-3862
Provider Credentialing
National1-800-624-0756
Mon-Fri 8am-6pm ET
Provider Relations
National1-800-441-5501
Mon-Fri 8am-7pm ET
Claims Inquiry
National1-800-624-0756
Quick Links
Aetna in Other States
Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.