Aetna dental fee schedule 2023

Effective Date: 01-01-2023. Dental Benefits Summary . DMO ® Member Responsibility Annual Deductible Individual None ... care dentist and authorized by Aetna Dental. If Aetna's payment to the specialty dentist is based on a negotiated fee, then the ... Services not listed in the Dental Care Schedule that applies, unless otherwise specified in ...

Fee Schedule Downloadable Information . Practitioner Fee Schedule Effective 01/01/2023 Updated 03/15/2023 (xls) Practitioner Fee Schedule Effective 12/31/2022 Updated 01/12/2023 (xls) (pdf) Practitioner Fee Schedule Effective 10/01/2022 Updated 12/01/2022 (xls) Practitioner Fee Schedule Effective 08/01/2022 Updated 10/31/2022 (xls) Practitioner Fee Schedule Effective 07/01/2022 Updated 08/25 ...The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical …Learn more about the network that over 67,000 dentists choose.Policy Type: Revised Applies To: In-network Texas providers rendering telemedicine or telehealth services to members of fully-insured commercial medical plans subject to Texas Insurance Code (TIC) Chapter 1455. Policy Implementation: Date of service Effective Date: January 1, 2018 Revision Date: See Policy Revision Date Applicable Insurance Code Section(s): TIC Sections 1455.001 - 1455.006 ...Member is responsible for all charges at the time of service. Fee schedules are subject to change without prior notification to members. Periodic oral evaluation - established patient ... If the General Dentist's normal fee for any dental procedure is less than the fee listed on this schedule, the dentist will charge 20% off of their normal fee ...The fee schedules and rates are provided as a courtesy to providers. Providers are to charge their reasonable and customary charge regardless of the anticipated reimbursement from the department. These are large and complex documents. Great care has been taken to make sure that the prepared documents and the claims payment system are the same.

an amalgam restoration plus the difference between the dentist's Aetna approved fees for the resin restoration and the amalgam restoration. Implant Supported Retainer for Porcelain Fused to Metal FPD (Titanium, Titanium Alloy or High ... DMO® Dental Benefits Summary Effective Date: 01-01-2018 Plan 54 Office Visit Copay PROCEDURE DIAGNOSTIC ...If you need emergency dental care for the palliative treatment (pain relieving, stabilizing) of a dental emergency, you are covered 24 hours a day, 7 days a week. When emergency services are provided by a participating PPO dentist, your co-payment/coinsurance amount will be based on a negotiated fee schedule.Training materials will be released in the summer of 2023 and will be posted on our Medicare page. ... No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. ... Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not ...Call us. Talk to a licensed agent at. 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare FAQs. Get answers to common Medicare questions. With most Aetna Medicare Advantage HMO plans, you typically choose an in-network primary care physician who works with you to help you get the right care at the right time.The Ontario government does not directly grant funds to individuals for private dental work. However, various programs supported by the province allow you to receive dental treatme...2023 GEHA PLAN MANUAL FOR DENTAL PROVIDERS Publication date: February 27, 2023 The 2023 GEHA Plan Manual for Dental Providers is intended solely as a reference guide. For complete ... • Cigna fee schedule: 800.244.6224 • Careington/DentaMax fee schedule: 800.441.0380 Option #8.. GEHA Page 5 of 58 Section 2. Resources and servicesIf you can't find the information you need or have additional questions, please direct your inquiries to: Billing Questions - Gainwell Technologies - (800) 807-1232. Provider Questions - (855) 824-5615. Prior Authorization - CareWise - (800) 292-2392. Provider Enrollment or Recertification - (877) 838-5085.Members love our low dental plan fees - that's why we are the premier dental plan! Dental Plan Membership Fees. Dental plan fees start at just $149 per year for individuals, $199 for couples, and $249 for the whole family. For the added flexibility of a monthly discount dental plan, individuals pay dental plan membership fees of $14 per month, couples pay $20 per month and it's only $24 ...

Ambulatory Surgical Center Facility Fees. Exhibit1A Final EO2 Version. Dental Fee Schedule. Exhibit2 Final EO2 Version. Private Nursing Care (per hour) Exhibit3 Final EO2 Version. Ambulance Services Fee Schedule. Exhibit4 Final EO2 Version. Durable Medical Equipment, Prosthetics, Orthotics Supplies.Call us. Talk to a licensed agent at. 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare FAQs. Get answers to common Medicare questions. Aetna offers a few different Medicare Advantage plans, including HMO-POS plans, PPO plans, and Dual Special Needs Plans (DSNP). Learn more about your Medicare Advantage …The Ontario Dental Association has placed copies of its fee guide in the reference section of a number of libraries in the area. As of February 2015, the guide is not accessible on...The first step in determining your fee increase for next year is balancing the practice fee schedule with an accurate data source that compiles filed insurance claims from your zip code. ... (CPI) is recording a 3.7% increase as of September 2023, and the dental sector continues to face higher-than-average expenses, eroding profit margins. The ...4968.2. 07/01/2021. Zipped Fee Schedules - 1st Quarter 2019. ZIP. 3974.3. 04/01/2019. Zipped Medicaid Policy Manuals 2019 - 2nd Quarter - Fee Schedules.

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Medical Procedures Billed By Physicians Or Other Practitioners. CPT Part 1 - Contains CPT Codes 0001F - 29999 - CSV. CPT Part 2 - Contains CPT Codes 3000F - 49999 - CSV. CPT Part 3 - Contains CPT Codes 50010 - 79999 - CSV. CPT Part 4 - Contains CPT Codes 80002 - 99607 - CSV. KY Medicaid Dental Fee Schedule 2023 Revised 11.29.2023 Proc Code Requirements Procedure Description UNDER AGE 21 Rate 21 and OVER Rate Notes D0270 DENTAL BITEWING-SINGLE RADIOGRAPHIC IMAGE $11.38 $8.75 Limited to four (4) per twelve (12) month period, per recipient, per provider. Bitewing X-rays shall not be covered in the same twelve (12 ... Contact Information. Aetna dental plans. Phone: 877-238-6200. Website: View Aetna Website. Group Number: 811221. Emory employees can choose from two types of dental plans: the Aetna Traditional Dental (PPO) or the Aetna Dental Maintenance Organization (DMO).R4 01/01/2023 Page: 1 of 13 Delta Dental of New Jersey, Inc. NJ Delta Dental PPO Fee Schedule (applies to General Dentists & Pedodontists) Fee Schedule - Effective 01/01/2023 *Important Note: All procedure codes may not be listed on this table. Fees for services which do not appear on thePer member per month (pmpm) Commission Schedule in most states. *CT, IN, and WI have a 2 member cap per policy, ME has a 3 member cap per policy, MO has a 1 member cap per policy, NH has a 4 member cap per policy, NV must have a minimum of 10 members, KY is a 1 time pay out in July, and VA is per contract. Last Updated: 11/9/2023.

*Anticipated national average dental charges for the 2004 calendar year based on the comparison of provider-negotiated fees to national average charges. Actual discount will vary based on location and services provided. **Actual costs and savings vary by geographic area. ***According to the Aetna Enterprise Provider Database as of 3/15/04Connecticut Provider Fee Schedule End User License Agreements. END USER LICENSE AGREEMENTS FOR CURRENT PROCEDURAL TERMINOLOGY (CPT) AND CURRENT DENTAL TERMINOLOGY (CDT) ARE DISPLAYED BELOW. TO ACCESS THE CONNECTICUT PROVIDER FEE SCHEDULES, REVIEW AND ACCEPT THE END USER LICENSE AGREEMENTS. CPT codes, descriptions and other data only are ...2023-2024 1 DENTAL SCHEDULE OF BENEFITS 2023-2024 BENEFIT PARTICIPATING PROVIDERS NON-PARTICIPATING PROVIDERS (Subject to Usual and Customary Charges) ... When you and your family seek dental care, you have access to Aetna's broad dental provider network. While you are permitted to see any Dentist when enrolled in the ASBAIT dental Plan ...DENTAL GENERAL FEE SCHEDULE January 1, 2023. 1. Procedure Code 0-20 Year Rate 21+ Year Rate Maximum Age Prior Authorization. DENTAL GENERAL FEE SCHEDULE January 1, 2023. D2391 46.28 20 D2392 61.21 20 D2393 76.13 20 D2394 91.06 20 D2710 114.95 20 D2721 126.90 20 D2740 340.37 20 D2751 340.37 20 D2920 25.38 20 D2928 101.52 D2930 101.52 20 D2931 [email protected] ; Live agents available: 24 hours per day, 7 days pe r week . Interactive voice response (IVR) system available: 24 hours per day/ 7 days per week ; Aetna Better Health Member Services Phone: 1-855-221-5656 (TTY: 711) Fax: 1-959-282-8852 ; Email: [email protected] Dental Preferred Provider Organization (PPO) Coverage 2010-2011 The Aetna Dental PPO insurance plan is underwritten and/or administered by Aetna Life Insurance Company (Aetna). 15.02.318.1 2 ... negotiated fee schedule. To save more, visit a network dentist. You will typically pay more if you visit a dentist outside the network.The Fee Schedules and Manuals below are Current. If you would like to view the Previous/Historic Fee Schedules and Manuals, please visit Fee Schedules and Manuals (Historic ). Fee Schedules . Ambulance Fee Schedule (Effective 1-1-23) (Effective 7-1-23) (Effectiv e 1-1-24)We review the best dental plans of 2023, including Delta Dental (Best for Braces); Humana (Best for Variety of Plan Options). By clicking "TRY IT", I agree to receive newsletters a...You can find all the phone numbers you need on our contact us page:. Member Services; Behavioral health services; 24-Hour Nurse Line: 1-800-556-1555 (TTY: 711) Help lines for STAR, STAR Kids and CHIP

Dental Benefit Administrative Services (CA only), United HealthCare Services, Inc. or their affiliates. Plans sold in Texas use policy form number DPOL.06.TX (11/15/2006) and associated COC form number DCOC.

1-800-368-1019, 800-537-7697 (TDD). Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, Coventry Health Care plans and their affiliates (Aetna).1 Platinum. DMO® Dental Benefits Summary.Nippon Life Insurance Company of America® - marketing name Nippon Life Benefits®, NAIC number 81264, licensed & authorized in all states plus DC, except not ME, NH or WY, domiciled in Iowa, with a principal place of business at 666 Third Avenue, Suite 2201, NY, NY 10017-9113, member company of Nippon Life Insurance Company of Japan (“Nissay”).No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms.Health plans are offered or underwritten or administered by Aetna Health Inc. (Texas) (Aetna). Aetna is part of the CVS Health ® family of companies. Health benefits and health insurance plans contain exclusions and limitations. Texas residents, find important benefits details for all Aetna CVS Health ACA individual plans available in your state.2023 fee schedule adds and changes Effective January 1, 2023, GEHA Connection Dental Network made the following CDT updates to our fee schedules. Please begin using these 2023 CDT codes on claims for treatment provided on and after January 1, 2023.2023 Aetna individual plans: Texas ... Aetna Dental Clinical Policy Bulletins (DCPBs) are developed to assist in administering plan benefits and do not constitute dental advice. ... No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Clinical ...Dental benefits. Plans that offer benefits through a network cover preventive care such as oral exams, cleanings and X-rays.*. Some plans include comprehensive services such as fillings and extractions. You can find specific benefit information in the Evidence of Coverage. Plans that offer DMR benefits cover most dental procedures, including ...

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Dentists and Dental Health Care Professionals. To protect the privacy of you and our members, your session has ended as a result of inactivity. Please click Continue below to log back in and resume your work session.The Council on Dental Practice elected to discontinue the Survey of Dental Fees in 2023 and it has been removed for download, due to a change in law eliminating safe harbor disclosure. Posting such information, therefore, is now legally problematic. Survey of Dental Fees is a national report gathered from a random sample of dentists on the fee ...The five character codes included in the Aetna Precertification Code Search Tool are obtained from Current Procedural Terminology (CPT ®), copyright 2023 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and ...Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Health benefits and health insurance plans contain exclusions and limitations. Get tools and guidelines from Aetna to help with submitting insurance claims and ...Members love our low dental plan fees - that's why we are the premier dental plan! Dental Plan Membership Fees. Dental plan fees start at just $149 per year for individuals, $199 for couples, and $249 for the whole family. For the added flexibility of a monthly discount dental plan, individuals pay dental plan membership fees of $14 per month, couples pay $20 per month and it's only $24 ...853875-01-01 (10/21) Aetna.com. Electronic claims submission. Use our electronic payer ID# 60054. Paper claims submission. Mail all claims to the address on the back of the member's ID card. Submit all paper claims as soon as possible using an Aetna® claims form. You can also use the standard CMS-1500 Health Insurance Claim form or the UB-04 ...In both the 2023 and 2024 Medicare Physician Fee Schedule Final Rules, the administration made changes to Medicare payment policies for certain dental services, in addition to other payment and ...Market Basket base rate increased by 4.1% to $10,840.00. The outlier threshold for 2023 is $79,500.00. Long Term Care Hospital (LTCH) Fee Schedule. Fee Schedule is based on Diagnosis Related Groups (DRGs) Market Basket base rate increased by 4.1% to $242,450. The outlier threshold for 2023 is $140,000.20.32. julho. 27°. 12°. 17.78. O weather.com oferece para você a previsão do tempo mais precisa para Uberaba, Minas Gerais com médias/recordes e temperaturas máximas/mínimas ... ….

Enroll for a one-time $20 start-up fee, and choose who's covered. Choose payments starting at $7.99 a month or $75 for the whole year. You can also cover your family for as little as $10.99 a month or $125 for the year. 3. Make an appointment directly with a particpating dentist. Be sure to mention you're a member of Vital Savings by Aetna.On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that announces finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2024.for 2024, MetLife will provide you with a confirmation letter only. If you were enrolled in the MetLife Federal Dental Plan in 2023 and continue coverage. (877) 638-3379 to confirm your enrollment in the Plan and the benefits available to you. benefits nor does your provider need it to render dental services.Medical supplies and durable medical equipment are reimbursed at cost times 1.5 plus $4.00 for handling fee charges. Charges greater than $50.00 must be accompanied by a copy of the wholesale vendor invoice (s) showing the actual cost of the item. Certain procedures include supplies; therefore, CPT code 99070 would not be reported.A Dental Implants é uma clínica odontológica especializada em implantes, estética e reabilitação oral. Que busca sempre a excelência na Odontologia, valorizando o melhor sorriso de cada um de seus clientes! #odontologia #dentalimplants #cirurgiaodentista +2. All reactions: 1.The CY 2024 Medicare Physicians Fee Schedule has been updated due to The Consolidated Appropriations Act, 2024. The fees are effective for dates of service March 9, 2024 through December 31, 2024. The CY 2024 MPFS fees posted are valid from January 1, 2024 through March 8, 2024.Dental coverage; Preventive Services; Medicare Coverage Center; End Stage Renal Disease (ESRD) Center ... Description January 2023 DME Fee Schedule Year 2023 File Name DME23-B. Description April 2023 DME Fee Schedule ... Description This file contains new fee schedule amounts for power mobility device codes K0800 thru K0864 …Policy Year: 2023 - 2024 Policy Number: 724536 www.aetnastudenthealth.com (877) 238-6200. This Aetna Dental® Preferred Provider Organization (PPO) insurance plan summary is provided by Aetna Life Insurance Company (Aetna) for some of the more frequently performed dental procedures. Under this plan, you may choose at the time of service either ...No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Aetna dental fee schedule 2023, KY Medicaid Dental Fee Schedule 2022 Revised 3/17/2022 Proc Code Procedure Description UNDER AGE 21 Rate 21 and OVER Rate Notes D2161 AMALGAM-FOUR/MORE SURFACES, PRIMARY OR PERMANENT $93.60 $72.00 D2330 RESIN-ONE SURFACE, ANTERIOR $57.20 $44.00 D2331 RESIN-TWO SURFACES, ANTERIOR $71.50 $55.00 D2332 RESIN-THREE SURFACES, ANTERIOR $85.80 $66.00, Policy Year: 2022 - 2023 Policy Number: 187467 www.aetnastudenthealth.com (877) 238-6200. This Aetna Dental® Preferred Provider Organization (PPO) insurance plan summary is provided by Aetna Life Insurance Company (Aetna) for some of the more frequently performed dental procedures. Under this plan, you may choose at the time of service either ..., Professional Services, Lab, X-Ray, Radiology and ASC. Rehabilitation Services Reimbursement Fee Schedule. Specialized Behavioral Health Fee Schedule. Take Charge Plus Fee Schedule. TPN Fee Schedule. Vision (Eye-wear) Fee Schedule. Obsolete Fee Schedules. The Louisiana Department of Health protects and promotes health and ensures access to ..., Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716.You also can mail a written request to Aetna PA, 1300 E. Campbell Rd., Richardson, TX 75081., October 2022 - Governor Beshear announces expanded dental benefits for adults on Medicaid including restorative treatment like fillings, crowns, implants, and dentures to begin in 2023. January 2023 - The Cabinet for Health and Family Services (CHFS) files emergency regulations to begin offering these benefits, including a rate increase for ..., 853875-01-01 (10/21) Aetna.com. Electronic claims submission. Use our electronic payer ID# 60054. Paper claims submission. Mail all claims to the address on the back of the member's ID card. Submit all paper claims as soon as possible using an Aetna® claims form. You can also use the standard CMS-1500 Health Insurance Claim form or the UB-04 ..., In the Main Menu, click Setup, Fee Schedules. In the Chart Module, in the Enter Treatment tab, click Procedure List. Click Fee Scheds. In Lists, Procedure Codes, at the bottom right, click Fee Scheds. Typically, the office creates a Fee Schedule for Usual, Customary, and Reasonable (UCR) fees and for each insurance company they are contracted with., We would like to show you a description here but the site won't allow us., Emergency Dental Care. If you need emergency dental care for the palliative treatment (pain relieving, stabilizing) of a dental emergency, you are covered 24 hours a day, 7 days a week. When emergency services are provided by a participating PPO dentist, your co-payment/coinsurance amount will be based on a negotiated fee schedule. , Precertification occurs before inpatient admissions and select ambulatory procedures and services. Precertification applies to: You can submit a precertification by electronic data interchange (EDI), through our secure provider website or by phone, using the number on the member's ID card. Check our precertification lists., Oct 15, 2022 · If you need your updated fee schedule before it’s online or if you’re a non-physician provider, fax your request and the CPT codes to 1-859-455-8650 after October 15, 2022. If you have questions, call the Provider Contact Center at 1-888 MD AETNA ( 1-888-632-3862) (TTY: 711). Thank you for your continued participation in the Aetna network. , Medical Procedures Billed By Physicians Or Other Practitioners. CPT Part 1 - Contains CPT Codes 0001F - 29999 - CSV. CPT Part 2 - Contains CPT Codes 3000F - 49999 - CSV. CPT Part 3 - Contains CPT Codes 50010 - 79999 - CSV. CPT Part 4 - Contains CPT Codes 80002 - 99607 - CSV., · This is a PPO dental plan and is supported by the Aetna Dental PPO Network. · Compensation will be based on your PPO fee schedule. · Deductible, coinsurance, annual maximums may apply. · An Explanation of Benefits (EOB) will be issued to help you determine what to collect from the patient., If you can't find the information you need or have additional questions, please direct your inquiries to: Billing Questions - Gainwell Technologies - (800) 807-1232. Provider Questions - (855) 824-5615. Prior Authorization - CareWise - (800) 292-2392. Provider Enrollment or Recertification - (877) 838-5085., Provider manual Resources, policies and procedures at your fingertips Aetna.com 3302205-01-01 (4/24), A crown is a tooth-shaped cap that replaces your normal tooth above the gum line. You may need a crown to support a weak tooth or to make your tooth look better. A crown is a tooth..., Aetna - Planes de seguro de salud y cobertura dental ... 2023 by the American Medical Association (AMA). ... dental. Los proveedores tratantes son los únicos ..., No fee schedules, basic unit values, relative value guides, conversion factors or scales are included in any part of CPT. Any use of CPT outside of Aetna Precertification Code Search Tool should refer to the most Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms., If you are interested in learning more about your dental plan, please contact Dr. Koplow in Colorado Springs today to schedule your appointment! Call our office at 719.473.9222 . Victory Dental Group is an Aetna Dental Provider in Colorado Springs. Contact us today to schedule your visit!, Aetna DMO Dental Benefits Summary. D0120 D0140. Periodic oral evaluation - established patient - 4 per year, all combined Limited oral evaluation - problem focused - 4 per year, all combined. No Charge No Charge. D0145. Oral evaluation for a patient under three years of age and counseling with primary care giver - 4 per year, all combined. , 2023 Fee Schedules Are Now in Effect ... Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., an affiliate of Blue Cross and Blue Shield of Florida. These companies are Independent Licensees of the Blue Cross and Blue Shield Association., D1354. Application of caries arresting medicament – per tooth. 27. All. 11, 12, 31, 32, 99. $25.00. No. 1 per tooth per day, maximum of 10 teeth per day, 4 times per tooth per year, 6 times per tooth per lifetime (Under 21 years of age only) T., The fee schedules and rates are provided as a courtesy to providers. Providers are to charge their reasonable and customary charge regardless of the anticipated reimbursement from the department. These are large and complex documents. Great care has been taken to make sure that the prepared documents and the claims payment system are the same., The UFT Scheduled Benefit Plan is administered by Connecticut General Life Insurance Company (CIGNA), P. O. Box 182531, Chattanooga, TN 37422-7531 800-577-0576 mycigna.com. You can obtain benefit payments for services rendered by participating or non-participating dentists only if you file the required dental claim form with Connecticut General ..., The most you pay for copays, coinsurance and other costs for medical services for the year. Once you reach the maximum out‐of‐pocket, our plan pays 100% of covered medical services. Your premium and prescription drugs don't count toward the maximum out‐of‐pocket. $295 per day, days 1‐5; $0 per day, days 6‐90., Aetna Dental works with ClaimConnect TM offered by EDI Health Group (EHG) to provide easy access to check patient eligibility, file a claim, check claim status, view patient rosters and Electronic Remittance Advice. Links to ClaimConnect and its content are provided for your convenience. Aetna Inc. and its subsidiary companies assume no ..., Here’s what’s new for 2023: For High Option members, you will pay nothing for in-network Class B and C services for children 13 and under. Standard Option members already receive this benefit. We will cover all overseas services at the in-network level for all members. Please note, this is a summary of features of Blue Cross Blue Shield FEP ..., Policy Year: 2023 - 2024 Policy Number: 724536 www.aetnastudenthealth.com (877) 238-6200. This Aetna Dental® Preferred Provider Organization (PPO) insurance plan summary is provided by Aetna Life Insurance Company (Aetna) for some of the more frequently performed dental procedures. Under this plan, you may choose at the time of service either ..., To review BCBSIL's Schedule of Maximum Allowances for PPO and Blue Choice PPO providers, you may submit a Fee Schedule Request Form to BCBSIL via fax, along with a signed Confidentiality Agreement. Significant changes to the physician fee schedules are included in the Blue Review provider newsletter. Specific code changes and annual and ..., Submit for a pretreatment estimate. You should submit a request for a pre-treatment estimate for procedures and services your dentist believes will exceed $300 (procedures such as crowns, inlays, bridges, and periodontics). For more information, call Aetna at 1-877-238-6200 or visit the Aetna website., *Anticipated national average dental charges for the 2004 calendar year based on the comparison of provider-negotiated fees to national average charges. Actual discount will vary based on location and services provided. **Actual costs and savings vary by geographic area. ***According to the Aetna Enterprise Provider Database as of 3/15/04, Extra benefits just for members. Your Aetna® plan offers extras to help you save money and feel your best. Enjoy wellness discounts, convenient walk-in clinic visits, digital tools to manage your care and more. Health insurance plans. Health Insurance Through Work., Legal notices. Dental plans and vision benefits are insured by Aetna Life Insurance Company (Aetna). Certain vision claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care ("EyeMed"), LLC. This material is for information only and is ...