Physicians and Medical Professionals
This page shows detailed information about the physician or other medical professional you have selected. Detailed information may include:

Plans: This is a listing of the Aetna plans in which the provider participates or accepts.

Hospital Affiliation: This is a listing of the hospitals where the provider has admitting privileges. If you require hospital care, you may be directed to one of the hospitals listed.

Other Office Locations: In addition to the address listed, the provider may have other office locations. You may view these locations by clicking on the "View Locations" link

Board Certification: When a physician is board certified, it means that he or she has applied for and been awarded certification from the American Board of Medical Specialties or the American Osteopathic Association. To become board certified, a physician must:

• Graduate from an accredited medical school
• Complete a specific type and length of training in a medical specialty
• Practice for a specified amount of time in that specialty
• Pass an examination given by the medical specialty board

Board certification is a voluntary process. Most certifying boards now require physicians to be recertified at specified intervals.

E-Pay Connectivity: E-Pay, an innovative approach to claims processing and payment, is an electronic referral and claims payment system that allows Aetna to process clean claims for payment within 15 business days of receipt. Participating physicians enrolled in E-Pay can get rapid payment turnaround of clean electronic claims in all of our products.

Health plan grid
This grid shows the various plans in which the provider participates. You can use this grid to compare provider plan participation and obtain additional information, including enrollment information for Primary Care Physicians.

Participating Plans: This is a listing of the Aetna plans in which the provider participates or accepts.

Provider ID: Number that uniquely identifies this provider. HMO providers may have multiple IDs. See the footnote at the bottom of the grid to determine the type of provider ID if there are multiples. If n/a appears in this column, then the provider does not have an ID number and is not a Primary Care Physician. These IDs may be needed to complete online transactions.

Network ID: (only required for Managed Choice and Elect Choice plans) Enter this number on your enrollment form if you are enrolling into either Managed Choice or Elect Choice. If n/a appears in this column, then you do not need this for enrollment.

Specialty/Patient Age Focus: This is the provider's specialty and, where applicable, information about whether or not the provider has a patient age specialization.

Provider Role: This field indicates whether or not the provider is a Primary Care Physician (PCP) or a Specialist. This may vary by plan.

Rate Your Medical Professional Survey: The Rate Your Medical Professional survey provides members with an opportunity to give feedback on Aetna participating providers and other providers available to members under their coverage with Aetna. It is used to collect feedback on PCPs, specialists and other medical professionals. The Survey allows members to indicate their level of satisfaction with their access to and relationship with the provider and the provider's office staff. You may view the survey results on this provider by clicking the "View Results" link.

Office Status: This field indicates whether a provider is accepting new patients, is accepting current patients only, or if his/her office is filled to capacity at this time. Please remember to always contact the provider's office to confirm office status.

To change your PCP online, go to the click on the "Change PCP" button.

Please use the "Request Data Correction" form to report any updates to provider data.