Credentialing Corner

Key Takeaways (What You Need to Do Right Now) 

• Aetna Medicare — Complete annual compliance training + attestation by October 31, 2026. Verify your compliance email immediately and finish MOC training if you participate in SNPs. 

• NYCE PPO — Effective January 1, 2026: Use Payer ID 26992 and the NYCE PPO Provider Portal (do NOT use Optum processes). Update your billing system and train staff today. 

• Evernorth / Cigna — Prior authorization for TMS is eliminated for in-network providers starting March 6, 2026. Accelerate credentialing if you are currently out-of-network. 

• MetroPlusHealth — Respond to BetterDoctor outreach every 90 days and ensure 24/7 patient access + accurate directory information to avoid removal from the network. 

St. Joseph’s Health — Contract renewed with Horizon BCBS and Braven Health. Update referral systems and stop all contingency planning.