Submitting Orthodontic Claims

Please include all of the following information with your first paper or electronic claim submission. This will help us determine benefits quickly and should eliminate the need for additional claims submissions.

  • Banding date
  • Number of months of treatment
  • Assignment of benefits information
  • ADA code
  • Total case fee
  • Primary insurance provider explanation of benefits (if coordination of benefits is necessary)
  • Prior insurance carrier information, including deductible, coinsurance/copay, maximum and amount paid to date (if patient is continuing active treatment)

Please follow these additional tips for submitting orthodontic claims to Aetna:

  • All orthodontic claims can be submitted electronically.
  • Orthodontic claims do not require clinical attachments or diagnostic casts.
  • Send only Initial Claim for Orthodontic Treatment Plans — Our system has been enhanced to automatically set up a regular payment schedule for most orthodontic treatment plans. Once we receive the initial claim indicating the banding date, total case fee, length of treatment and all other required claim details, our system will automatically release the appropriate monthly/quarterly installment payment for the member’s treatment plan, as long as he/she remains eligible for benefits.

See Tips for submitting claims to Aetna for additional quick tips.

News
You are now leaving the Aetna Dental website.

Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.

Continue >
You are now leaving the Aetna Dental Web site and linking to ClaimConnect*.

Aetna Dental works with ClaimConnectTM 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 responsibility for any circumstances arising out of the use, misuse, interpretation or application of any information or other material provided by EDI Health Group (EHG). Aetna Inc. and its subsidiary companies do not endorse any of the products or services available through EHG. EHG independently develops and maintains its own privacy policies and practices.

*ClaimConnect is a registered trademeark of EHG (EDI Health Group, Inc.) and its subsidiaries.

Continue >