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
Aetna Better Health of New Jersey uses DentaQuest to provide dental services to our members. DentaQuest is responsible for covering routine and specialty dental services, the administration of the dental network, and claim payment for dental services. You can reach DentaQuest at 1-855-225-1727, Monday – Friday from 8 a.m. to 5 p.m.
Network dentist can view the DentaQuest provider web portal.
Members do not need a referral to see a network dental provider. You can view DentaQuest’s online provider search to find a dentist.
NJ SMILES Program
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: