We are in-network with all Aetna PPO dental plansWe have never been in-network with any Aetna HMO plansAetna does not notify us of any plan changes until a claim is submitted on behalf of the patientI believe there was miscommunication in regards to the confirmation of the insuranceWe confirmed that you still had Aetna; which is accurateWhere the miscommunication came, was that while you were still insured with Aetna, you had chosen to change your plan to an HMO rather than a PPOTherefore, while confirming Aetna was still the dental carrier without notifying us of the change from PPO to HMO, we unknowingly could not provide accurate estimates for your insurance coverageWe do not have an automatic eligibility services, nor does Aetna communicate with us regarding policy changes, until a claim is processedIf there is a change such as going from PPO to HMO, we need to knowEither this is providing us with a new group number, or ID number, or simply stating that it is now an HMO policyNone of this information was provided to usThis is why there was a discrepancyBecause we never have been nor ever will be in-network with HMO insurances, we understand that they do not provide any out of network benefits for the patientsWe would have let you know immediately that there are not any out-of-network benefits for youIf the patient knew there was a new HMO policy, it is important we are made awareThis would've resolved the issue immediatelyHMO insurances are very specific with their coverage and make the patient select their specific provider and are often limited to their coverageThis should be discussed with the insurance plan administratorThe plan administrator should provide the patient with their dental benefitsWhile the balance was a surprise to the patient who was unaware of her new insurance benefits, the services were still rendered at our officeNormally, if a patient chooses to come to our office with an HMO or no insurance, we charge our standard office fees which would be as follows: Recall Cleaning/Exam for $and a 2-Surface filling for $292, or a total of $However, as an effort to reconcile, we honored in-network Aetna PPO fees for the services renderedTherefore, the services were discounted to a total of $This is a discount of $While, I know the patient prefers to pay nothing for the services, we are unable to accommodate more than the discount we had already providedWe try our best to provide accurate information to the patient; however, it is the patient's responsibility to be aware of their insurance coverageWe verify benefits as a courtesy to the patient, but we always make the patient aware it is only based off of the information you provide and still an estimate at best
We are in-network with all Aetna PPO dental plansWe have never been in-network with any Aetna HMO plansAetna does not notify us of any plan changes until a claim is submitted on behalf of the patientI believe there was miscommunication in regards to the confirmation of the insuranceWe confirmed that you still had Aetna; which is accurateWhere the miscommunication came, was that while you were still insured with Aetna, you had chosen to change your plan to an HMO rather than a PPOTherefore, while confirming Aetna was still the dental carrier without notifying us of the change from PPO to HMO, we unknowingly could not provide accurate estimates for your insurance coverageWe do not have an automatic eligibility services, nor does Aetna communicate with us regarding policy changes, until a claim is processedIf there is a change such as going from PPO to HMO, we need to knowEither this is providing us with a new group number, or ID number, or simply stating that it is now an HMO policyNone of this information was provided to usThis is why there was a discrepancyBecause we never have been nor ever will be in-network with HMO insurances, we understand that they do not provide any out of network benefits for the patientsWe would have let you know immediately that there are not any out-of-network benefits for youIf the patient knew there was a new HMO policy, it is important we are made awareThis would've resolved the issue immediatelyHMO insurances are very specific with their coverage and make the patient select their specific provider and are often limited to their coverageThis should be discussed with the insurance plan administratorThe plan administrator should provide the patient with their dental benefitsWhile the balance was a surprise to the patient who was unaware of her new insurance benefits, the services were still rendered at our officeNormally, if a patient chooses to come to our office with an HMO or no insurance, we charge our standard office fees which would be as follows: Recall Cleaning/Exam for $and a 2-Surface filling for $292, or a total of $However, as an effort to reconcile, we honored in-network Aetna PPO fees for the services renderedTherefore, the services were discounted to a total of $This is a discount of $While, I know the patient prefers to pay nothing for the services, we are unable to accommodate more than the discount we had already providedWe try our best to provide accurate information to the patient; however, it is the patient's responsibility to be aware of their insurance coverageWe verify benefits as a courtesy to the patient, but we always make the patient aware it is only based off of the information you provide and still an estimate at best