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    • Taking complexity out of oral surgery coverage and claims

    Sometimes, oral surgery claims can be confusing. So we’ve made them easier and less stressful with our one-of-a-kind Oral Surgery Center of Excellence (OSCoE).

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    Oral surgery, without the hassle

    < 1% of the 400000, oral surgery claims handled annually by the OSCoE require reworking

    Oral surgery, without the hassle

    Oral surgery claims can be complex, but getting them paid doesn’t have to be. When members combine our dental and medical coverage, it’s a win-win situation.

     

    We designed the OSCoE to handle claims and calls only related to oral surgery. Our dedicated OSCoE team is cross-trained on both dental and medical platforms for traditional and HMO plans. This ensures individual oral surgery claims are correctly processed against a member’s medical or dental coverage.

     

    *That’s down almost 45% of claims reworked before the OSCoE launched in 2002. (Based on 2017 Aetna internal claims data.)
     

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    Simplifying the experience

    For members with both our medical and dental plans, the OSCoE can help with:  

    Understanding and verifying coverage

    Finding oral surgery providers

    Making sure claims are processed correctly

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    Claims made simple

    Our OSCoE seamlessly handles oral surgery procedures that have services falling under both dental and medical coverage. Here’s how a member claim plays out:

     

    1. Laura* goes to her oral surgeon for wisdom teeth extractions and a lesion removal.

    2. Her wisdom teeth are impacted. The extractions and related services, like exam, X-rays and anesthesia, fall under her dental plan.

    3. The lesion removal is covered under her medical plan.

    4. Laura has our dental and medical coverage, so the claim is sent directly to the OSCoE.

    5. The OSCoE processes the claim correctly — the first time. And her recovery can be stress-free.
       

    *For illustrative purposes only; does not reflect events experienced by an actual participant.

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    Find out more about how our insurance products can help.

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    Legal notices

    In Idaho, dental benefits and dental insurance plans are offered and/or underwritten by Aetna Life Insurance Company. For all other states, dental benefits and dental insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Dental Inc., Aetna Dental of California Inc. and/or Aetna Life Insurance Company (Aetna). Each insurer has sole financial responsibility for its own products.

    This material is for information only. Dental benefits and dental insurance plans contain exclusions and limitations. Dental information programs provide general dental information and are not a substitute for diagnosis or treatment by a dentist or dental health professional. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to dental services. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna® plans, refer to aetna.com.

    Policy forms issued in Oklahoma include: GR-9N, GR-23 and/or GR-29N.

    Policy forms issued in Idaho include: GR-9/GR-9N, GR-23, GR-29/GR-29N, AL HGrpPol-Dental 01.

    Policy forms issued in Missouri include: AL HGrpPol-Dental 01, DM HGrpAg 01
     

    See all legal notices