DMO Plan: Your primary care dentist will file claims for you. In the event of an emergency, call the toll-free DMO Member Hotline (800-843-3661) to get instructions on filing a claim.
To check the status of a DMO claim, call the Member Hotline (800-843-3661).
PPO Dental Plan: Before you or a covered dependent goes to the dentist, obtain a claim form and follow the instructions on the form. Take the form with you on the first visit (if emergency treatment is required and you cannot get a claim form in advance, you can obtain a form afterward and then get it to the dentist as soon as you can). The dentist in most cases will complete the form and send it to Aetna for you.
For services which the dentist estimates will exceed $300, you may request the dentist to submit a treatment plan to Aetna to make a “pre-determination” of benefits. Aetna will review the proposed treatment plan and send a written determination of benefits to you and the dentist. At that point, you and the dentist can decide whether to continue with the original treatment plan or make changes. Your dentist will submit the claim to Aetna once the work is completed.
The address for submitting PPO Dental Plan claims is:
Group Dental Claim Division
P. O. Box 14094
Lexington, KY 40512-4094
For claim status or general questions, call Aetna at (800) 445-2283.