Provider services

Our Provider Services Department serves as a liaison between the Health Plan and the provider community. 

We will work with you in:

  • Conducting onsite provider training
  • Helping identify and resolve problems
  • Conducting provider office visits
  • Setting up accessibility audits

We can help you

Our Provider Services Representatives are available by phone at 1-855-232-3596 or email to support all providers. Some of the everyday actions we take to help you include:

  • Notifying you of an address change
  • Keeping track of member updates
  • Locating forms
  • Reviewing member information
  • Checking member eligibility
  • Finding a participating provider or specialist
  • Submitting a prior authorization
  • Reviewing or searching the Preferred Drug List/formulary
  • Notifying the plan of a provider termination
  • Notifying the plan of changes to your practice
  • Advising a Tax ID or National Provider Identification (NPI) Number change
  • Obtaining a secure web portal or member care Login ID
  • Reviewing claims or remittance advice

Our Provider Services Department supports multiple functions in network development and contracting. This includes evaluation of the provider network, and compliance with regulatory network capacity standards. Our staff is responsible for the creation and development of provider communication materials, including the Provider Manual, periodic provider newsletters, bulletins, fax/email blasts, website notices and the provider orientation kit. 

Need assistance? Contact us

Janice Poinsett

Network Relations Consultant

Service Area: Southern NJ

Counties: Ocean, Burlington, Camden, Gloucester, Salem, Cumberland, Cape May, Atlantic

Office: 609-282-8185

Cell: 609-613-8022

Fax: 860-900-7315

PoinsettJ@aetna.com

Towanna Richardson

Network Relations Consultant

Service Area: Northern NJ

Counties: Sussex, Passaic, Warren, Morris, Bergen, Essex and Hudson

Office: 959-299-3251

Cell: 609-240-3354

Fax: 959-282-8644

RichardsonT3@aetna.com

 

Mary Pagano

Network Relations Consultant      

Service Area: Central NJ

Counties: Union, Middlesex, Hunterdon, Somerset, Mercer and Monmouth

Office: 609-282-8231

Cell: 609-578-0562

Fax: 959-282-8925

PaganoM@aetna.com

Christina Duncan

Network Relations  Consultant

Service Area: MLTSS for all of NJ LTC, HCBS, AL, Hospice, Nursing Facility, Specialty Care Nursing Facility claim and servicing issues

Office: 609-282-8194

Cell: 609-580-0202

Fax: 959-888-4462

DuncanC1@aetna.com

 

Jessica Perez

Contract Negotiator

Office: 609-282-7976

Cell:  609-664-8248      

Fax: 959-282-8627

PerezJ8@aetna.com

Adam Manna

Network Manager

Cell: 609-917-0085

Fax: 959-282-8088

MannaA@aetna.com