Aetna Dental Plans Claims Submission

COPY EXCERPT: Aetna Dental Plans Claims Submission
Copywriting by Zoë Stetson

Submit electronically: Electronic claims and encounters (including DMO® plans, orthodontic and predeterminations) typically experience faster reimbursement and fewer rejections. Electronic submissions must indicate the billing dentist’s National Provider Identifier (NPI) and the pay-to dentist’s NPI if they are not the same.

Call in dates of service for existing predeterminations: A predetermination is not required, but it is suggested to help the patient understand his or her benefits before a procedure is performed. If you submit a predetermination, you will not need to submit a final claim as long as the services match. Once the service is performed, simply call our National Dentist Line (1-800-451-7715) with the dates of service.

Include tooth numbers: A claim for a periodontal procedure must include the quadrant ID. If it is not a full quadrant, include the tooth numbers involved in the procedure. Submit prior periodontal history for patients covered under a new policy. Also, include the numbers of all other missing teeth and dates of extraction when submitting claims for prosthodontics.

Download a PDF of the Aetna Dental Plans Claim Submission.