We want to educate our members about the importance and value of dental care as part of the overall treatment of their medical conditions, so they'll be encouraged to visit their dentist regularly. Aetna member claims data automatically triggers our Dental Medical Integration (DMI) Program.
It's seamless. Since we have both medical and dental claim information, we can see who's at risk. Our DMI Program focuses on members who are pregnant, or have diabetes, heart disease and/or cerebrovascular disease. Enrollment for these members is automatic. There is no extra paperwork to complete by dentists or our members.
We reach out to at-risk members who have not gone to the dentist in the last 12 months. These members will get educational material explaining the link between periodontal disease and their health condition. We urge them to call our dental care coordinators to:
If a member does not visit a dentist after receiving our educational material, our dental care coordinators will follow up.
The program also offers the at-risk member enhanced benefits. These benefits are covered in full with no deductible:
The payment for these services is automatic as our system knows if a member is enrolled in the DMI Program.
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.Continue >