Dental Services

Click the drop down menus below for information on providing dental services to Aetna Better Health of New Jersey members. To learn more about our dental benefits, view our Provider Manual

Below are links to websites that were available as of May 22, 2020 for the New Jersey Division of Consumer Affairs, the American Dental Association, the American Academy of Pediatric Dentistry, the Center for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA).  These are reliable sources which offer safety and infection control standards, practice management guidelines and other topics to be considered when reopening your dental office.  It is your responsibility to comply with federal and state regulations, so it is recommended that you visit each of these websites regularly for updates.

New Jersey Division of Consumer Affairs – In addition to adhering to the requirements outlined in their 5/22/2020 email date sent to NJ licensed dental professionals, see the link to Reopening of dental offices (5-15-2020) and check the website for additional guidance.

https://www.njconsumeraffairs.gov/COVID19/Documents/DCA-AO-2020-07.pdf

 

American Dental Association (ADA) COVID-19 Updates &resources, OSHA Guidance and Return to work Interim Tool Kit

https://success.ada.org/en/practice-management/patients/infectious-diseases-2019-novel-coronavirus?utm_source=adaorg&utm_medium=VanityURL

 

Center for Disease Control (CDC) – Dental settings

https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

 

Occupational Safety and Health Administration (OSHA) May

https://www.osha.gov/SLTC/covid-19/dentistry.html

 

The American Academy of Pediatric Dentistry (AAPD) updates and information. 

https://www.aapd.org/about/about-aapd/news-room/infection-control/

 

The AAPD also has a Re-emergence Pediatric Dentistry Practice Checklist available on their website to members.

Aetna Better Health of New Jersey uses LIBERTY Dental Plan to provide dental services to our members. LIBERTY Dental Plan is responsible for covering 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 – Friday from 8 a.m. to 8 p.m.

Network dentist can view the LIBERTY Dental Plan provider web portal. 

Members do not need a referral to see a network dental provider. You can view LIBERTY Dental Plan's online provider search to find a dentist.

Through the NJ Smiles Program, primary care providers who access the appropriate training can provide fluoride varnish to the teeth of children as a preventive measure against caries.

Non-dental providers can provide caries risk assessment, fluoride varnish application and dental referral for children through the age of six. Fluoride varnish may be applied by non-dental providers who have proof of training for this service. Primary care providers (pediatricians or physicians seeing pediatric enrollees), physician assistants and nurse practitioners can receive this training.

Fluoride varnish application will be combined with risk assessment and referral to a dentist that treats children under the age of six and will be linked to well-child visits for children through the age of six. These three services will be reimbursed as an all-inclusive service billed using a CPT code and can be provided up to four times a year. This frequency does not affect the frequency of this service by the dentist. A referral to a dentist for a dental visit by 12 months of age is required by the state periodicity schedule. 

All primary care dentists and primary care providers should be up-to-date on prescribing fluoride supplements (based on access and use to fluoridated public water) and their responsibility in counseling parents and guardians of young children on oral health and age appropriate oral habits and safety to include what dental emergencies are and use of the emergency room for dental services.

The caries risk assessment service shall also be allowed by the primary care dentist and is billed using a CDT procedure code. The reimbursement will be the same regardless of the determined risk level. The risk assessment must be provided at least once per year in conjunction with an oral evaluation service by a primary care dentist and is linked to the provider not the member. It may be provided a second time with prior authorization and documentation of medical necessity.

Tools and forms for NJ SMILES: