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Dental services
A healthy smile is linked to a healthy body. That’s why we encourage members to see their dentist every six months. Members can get dental care when they join Aetna Better Health® of New Jersey. Just remind them to bring their member ID card to every visit.
Questions?
Learn more about dental services in your provider manual (PDF). You can also check the member benefits page.
Reopening dental offices during the COVID-19 pandemic
Reopening dental offices during the COVID-19 pandemic
Be sure to comply with federal and state regulations. You can stay current on regulations by checking these reliable sources (effective May 22, 2020) that follow for guidance on:
- Safety and infection control standards
- Practice management guidelines
- Other topics to consider when you reopen your dental office
You’ll want to check these resources:
- The May 22, 2020 email to NJ licensed dental professionals (with outlined requirements)
- Consumer Affairs website
- Administrative Order for Healthcare Services Office Practices (PDF)
ADA Coronavirus (COVID-19) Center for Dentists
Centers for Disease Control (CDC): Guidance for dental settings
Occupational Safety and Health Administration (OSHA) May: Dentistry workers and employers
The American Academy of Pediatric Dentistry (AAPD): Infection control
Re-emergence pediatric dentistry practice checklist (for members)
LIBERTY Dental Plan providers
We use LIBERTY Dental Plan to provide dental services to our members. We cover routine and specialty dental services, the administration of the dental network and claim payment for dental services.
You can reach LIBERTY Dental Plan at 1-855-225-1727, Monday to Friday, from 8 AM to 8 PM.
Network dentists can use the LIBERTY Dental Plan provider web portal to submit claims, check payment status and more.
Members don’t need a referral to see a dental provider in our network. They can use the LIBERTY Dental Plan Find a dentist tool to locate in network dentists and specialists, dentists treating children under six years of age and dentists who treat adults and children with intellectual and developmental disabilities.
The LIBERTY Dental Plan Find a dentist tool
The NJFC Directory of Dentists Treating Children under the Age of 6 (PDF)
NJ FamilyCare Dental Services Clinical Criteria (PDF)
Directory of Dentists Treating Members with Intellectual and Developmental Disabilities Adult (PDF)
Directory of Dentists Treating Members with Intellectual and Developmental Disabilities Child (PDF)
Aetna NJ Child Provider Directory (PDF)
New Jersey SMILES program
New Jersey SMILES program
If you’re a primary care dentist or provider, you’ll want to counsel parents and guardians of young children about:
- Oral health
- Age-appropriate oral habits and safety
- Dental emergencies and where to get care
- Use of the emergency room for dental services
Be sure to stay up to date on prescribing fluoride supplements (based on access and use of fluoridated public water).
We encourage medical providers to apply fluoride varnish to children’s teeth, perform dental assessments and promote routine oral heath visits for our young members.
For children up to age 6, nondental providers can offer:
- Fluoride varnish application (with proof of training)
- Caries risk assessment
- Referral to a dentist that treats children under the age of 6 (during regular well child visits for children 72 months or younger)
These services combine for reimbursement as an all-inclusive service and bill with a CPT code. They can be provided up to four times a year. This frequency is separate from services a dentist provides.
Primary care providers (PCPs) who get training can provide fluoride varnish to the teeth of children as a preventive measure against caries. PCPs (pediatricians or physicians seeing pediatric enrollees), physician assistants, and nurse practitioners can receive this training.
Primary care dentists can also provide the caries risk assessment service and bill with a CDT procedure code. Reimbursement is the same, no matter what the risk level. The risk assessment:
- Must be provided at least once a year, along with an oral evaluation service by a primary care dentist
- Is linked to the provider, not the member
- May be provided a second time with prior authorization (PA) and documentation of medical necessity
- We can reimburse participating pediatricians, nurse practitioners and physician assistants for the application of fluoride varnish if they’ve completed an online training curriculum or received training from a trained provider.
- We’ll reimburse pediatricians $25 for each varnish application every three months on members up to age 6.
- We can only reimburse trained providers. One provider per facility needs to complete the online training. Then, they can train their colleagues. Choose course 6: Caries Risk Assessment, Fluoride Counseling in the right column.
- Providers who have completed the training must sign an attestation form. Then, fax the form to Joseph Maggio at 860-607-8842. Aetna Better Health of New Jersey’s training attestation must be completed before reimbursement.
