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Aetna dmo specialty referral form 2025

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The document is an Aetna Managed Dental Specialty Referral Form for Direct Referral to participating Specialty Dentists under a DMO plan. It includes sections for employee and patient information, referral details, and required approvals for various dental specialties such as endodontics, oral surgery, pediatrics, periodontics, and orthodontics. The form emphasizes the necessity of including supporting diagnostic materials and obtaining prior approval for certain procedures to ensure eligibility for benefits.

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2019	4.8 Satisfied (86 Votes)
2014	4.3 Satisfied (21 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is a DMO referral?

In the DMO insurance plan, you have to choose one of the primary care dentists in your area who will look after your general dental health problems. However, if your dentist determines that you need to see a specialist, he can refer you to one, and you dont have to pay any extra cost for that.

What does DMO mean for dental insurance?

The full form of Dental DMO is Dental Maintenance Organization. It is a type of dental coverage insurance. Dental Maintenance Organization is a network of specialist dentists who provide various dental care services at a fixed cost.

What does DMO mean in Aetna?

Aetna Dental Maintenance Organization (DMO) A DMO is a network of dentists and specialists who provide dental care services at a fixed cost. With the DMO, a participant does not have to meet a deductible or file any claim forms. The Aetna DMO is available only in areas where there are participating dentists.

Why is DMO so cheap?

The cost of premiums is lower because the insurance company is not paying out money on claims. This type of insurance can be very affordable for patients with limited dental needs.

Does Aetna insurance require a referral to see a specialist?

We cover the cost of care based on your choices. With Aetna Elect Choice plans, you are required to get a referral from your PCP before you can see a specialist. A referral is a written request for you to see another doctor. Some doctors can send the referral right to your specialist for you.

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Key Facts about Aetna Managed Dental Specialty Referral Form

Eligibility for Direct Referral

Mandatory Inclusion with Claims

Dependent Information Required

Approval Required for Certain Procedures

Emergency Care Exemption

Supporting Diagnostic Material Needed

Contact Information Provided

Eligibility for Direct Referral

The form is specifically for direct referrals to participating specialty dentists under the DMO plan.

Mandatory Inclusion with Claims

This referral form must be included when submitting a universal claim form for payment or specialty approval.

Dependent Information Required

If the claim is for a dependent, additional patient information such as name and date of birth must be provided.

Approval Required for Certain Procedures

Procedures marked with an asterisk (*) require prior approval before referral can be made.

Emergency Care Exemption

Approval is not required if emergency care is needed from a pediatric dentist beyond the primary care dentist's scope.

Supporting Diagnostic Material Needed

When submitting requests for approval or reimbursement, supporting diagnostic material must be included to avoid compensation issues.

Contact Information Provided

The form includes contact details for inquiries, specifically a phone number (1-800-451-7715) for questions related to the referral process.

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What is the difference between a DMO and a PPO?

PPO: Higher premiums and co-pays, but greater freedom in choosing providers. DMO: Lower costs, but with stricter network limitations.

Is Aetna DMO the same as PPO?

Consider a PPO plan if The ability to visit any dentist is most important. You can see any licensed dentist with this plan, so the network is generally larger than the DMO network. You are looking to see a specialist without having to get a referral. You dont need a referral to see a specialist with this plan.

Aetna dmo specialty referral form 2025

Here's how it works

The best way to change Aetna dmo specialty referral form online

See more aetna dmo specialty referral form versions

Complete this form in 5 minutes or less

Got questions?

What is a DMO referral?

What does DMO mean for dental insurance?

What does DMO mean in Aetna?

Why is DMO so cheap?

Does Aetna insurance require a referral to see a specialist?

Key Facts about Aetna Managed Dental Specialty Referral Form

Eligibility for Direct Referral

Mandatory Inclusion with Claims

Dependent Information Required

Approval Required for Certain Procedures

Emergency Care Exemption

Supporting Diagnostic Material Needed

Contact Information Provided

Eligibility for Direct Referral

Mandatory Inclusion with Claims

Dependent Information Required

Approval Required for Certain Procedures

Emergency Care Exemption

Supporting Diagnostic Material Needed

Contact Information Provided

Complete this form in 5 minutes or less

People also ask

What is the difference between a DMO and a PPO?

Is Aetna DMO the same as PPO?

aetna dental referral form

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