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Aetna Advantage plans provide dental benefits through either the Aetna network or direct member reimbursement (DMR). This online tool can help a person find providers that accept their Advantage plan.
In addition, payment to dental professionals is based on the CDT code(s) reported on the ADA Claim Form, so using the most current codes helps to maximize reimbursement and minimize audit liability. [6] In the near future, dental professionals will be required to use diagnosis codes in support of the procedures and services they provide.
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
In addition to their own research, health insurers Aetna, [15] [16] [17] Humana [18] and UnitedHealth Group [19] have all provided their own claims data for independent analyses by the Health Care Cost Institute. [20] The RAND Health Insurance Experiment (1974–1982) is considered "one of the best experimental social science studies ever ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Physicians Mutual is a mutual insurance company headquartered in Omaha, Nebraska, United States.It consists of Physicians Mutual Insurance Company and Physicians Life Insurance Company.