Question just about dental insurance?
My dentist siad he couldn't get any money from Aetna because my plan is DMO. Is it possible? The dentist clean my teeth and do the other work and I even don't stipulation to pay copayment. Why the dentist accept this plan if they can't receive any money from insurance company?
Answers:
You must have misunderstood. Of course the dentist gets salaried by Aetna if you are part of the Aetna DMO insurance plan. That's exactly what the plan does -- it pays the dentist for whatever treatments he give you that are covered under the plan.
A DMO (Dental Maintenance Organization) is similar to an HMO (Health Maintenance Organization). When you sign up, you choose a primary care dentist. If the dentist is not your primary care dentist, his services are not covered.
He is not required to describe you that he is not part of the network. That is your responsibility prior to have services.
EDIT:If he is in the DMO network and down as a primary care dentist with Aetna, you obligation to talk to Aetna about what he is recitation you. If they have denied his claim, you should have also received the EOB and denial. Do not simply pocket his word for it.
If he's not in network, and you didn't select him as your service provider, he isn't getting salaried.
YOU have to set it up, that he gets rewarded. He only gets compensated $10 a month by Aetna, for each patient who signed up UNDER HIM.
An analogy here. Your employer pays you. I want you to come over to my house, and paint it. Next week would be great. It shouldn't be a problem, because you're getting rewarded by your employer! Right? Wrong. You only want to work for the guy paying you. He only requirements to work for the guys paying HIM.
Maybe he said he won't get MUCH money...he'll manifestly receive less through the plan than if you don't use insurance.
Related Questions:
Answers:
You must have misunderstood. Of course the dentist gets salaried by Aetna if you are part of the Aetna DMO insurance plan. That's exactly what the plan does -- it pays the dentist for whatever treatments he give you that are covered under the plan.
A DMO (Dental Maintenance Organization) is similar to an HMO (Health Maintenance Organization). When you sign up, you choose a primary care dentist. If the dentist is not your primary care dentist, his services are not covered.
He is not required to describe you that he is not part of the network. That is your responsibility prior to have services.
EDIT:If he is in the DMO network and down as a primary care dentist with Aetna, you obligation to talk to Aetna about what he is recitation you. If they have denied his claim, you should have also received the EOB and denial. Do not simply pocket his word for it.
If he's not in network, and you didn't select him as your service provider, he isn't getting salaried.
YOU have to set it up, that he gets rewarded. He only gets compensated $10 a month by Aetna, for each patient who signed up UNDER HIM.
An analogy here. Your employer pays you. I want you to come over to my house, and paint it. Next week would be great. It shouldn't be a problem, because you're getting rewarded by your employer! Right? Wrong. You only want to work for the guy paying you. He only requirements to work for the guys paying HIM.
Maybe he said he won't get MUCH money...he'll manifestly receive less through the plan than if you don't use insurance.
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