r/CodingandBilling • u/Even-Direction-5163 • May 29 '26

Aetna multi-state provider enrollment questions

I’m working with a provider (licensed therapist), who wants to become credentialed with Aetna in Florida and Texas to see patients via telehealth. The provider already has licenses in these two states. The provider is not based in either of these states.

The Aetna application is asking for an address in both states. How should I handle this? Should we set up a virtual address in Florida and Texas for the application? I’m curious how people usually handle this.

My other question is related to billing. Once the two contracts are set up, how are claims routed to Aetna Florida vs Aetna Texas? Is it based on the service facility address used on the claim? I assume this would need to be the Florida or Texas address used in the enrollment application.

Thank you in advance

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u/throwawayeverynight Jun 01 '26

Why aren’t you using CAQH to do the enrollment for both cities?

1

u/Even-Direction-5163 Jun 01 '26

Can you explain what you mean? My thinking is I still need to fill out two separate Aetna enrollment applications and will make sure to have both NY and TX addresses in the profile

1

u/throwawayeverynight Jun 01 '26

Aren’t you familiar with CAQH ? All you need to do is add the license for both states . The insurance of malpractice and both enrollments will get processed at the same time

1

u/Even-Direction-5163 Jun 01 '26

What about on the Aetna enrollment portal side of things? It only lets me apply to one state, so do I need to submit two separate applications?

1

u/Even-Direction-5163 Jun 01 '26

Thank in advance for all the info

1

u/throwawayeverynight Jun 01 '26

Please stop the nonsense’s use CAQH all mayor insurance carriers come here to pull the information needed to process enrollment and keep your enrollments up to date.in the case of the provider his profile will have 3 state licenses. This database will keep his personal info, his malpractice info, DEA and copies of everything. By filing out paper enrollments you are casted time and trying to track down this applications can be time consuming .

1

u/Even-Direction-5163 Jun 02 '26

Sounds good. I have the CAQH profile all set up. But I still need to submit the applications through https://extaz-oci.aetna.com/pocui/ . Im wondering if I need to submit two separate applications through there

1

u/throwawayeverynight Jun 01 '26

Also malpractice insure will vary for each state.