Dental (Oral Health)

Oral health is not just about the teeth, but the health of the whole mouth and even the body. Aetna Better Health of Pennsylvania knows having a great smile, can even affect your confidence and we want all of our members to have a great and healthy smile.

We now cover ALL levels of dental cleanings (including deep cleanings and more) for ALL members of ALL ages starting January 1st, 2019!

  • Even though you may not provide Oral Health care at your office, you still play a vital role in helping our members’ oral health. How can you help?
    • Refer all members to a dentist. Click here for a listing of dental providers in your area

Periodontal Disease:

Periodontal disease can exacerbate physical health conditions such as diabetes.  Click here to learn about periodontal disease, its link to overall physical health, and treatment.

Annual Dental Visit HEDIS Document

Click on this document to not only learn about the Annual Dental Visit HEDIS measure, but also about the importance of preventive dental services, coding tips for capture of care, the 2020 incentive for dental practitioners, strategies for improvement, and new covered benefits for members in 2020!

Aligning with the Pennsylvania Oral Health Plan

Aetna Better Health of Pennsylvania and Aetna Better Health Kids are aligning with goals in the 2017-2020 Pennsylvania Oral Health Plan to prevent oral health disease and improve overall health outcomes for all our members. Refer to this document for information on how you can partner with the Aetna Better Health of Pennsylvania Dental Director and Quality Practice Liaison (QPL) program to achieve these goals.

Dental Billing Guide

Refer to this comprehensive guide for information on accepted CDT codes, satisfying the Oral Health Performance Measures, and assistance with qualifying for Pay for Quality Incentives.

 

In 2020, Aetna Better Health of Pennsylvania will be educating our dental provider network on five key performance measures. These measures focus on key quality domains such as prevention and access to care. Click on each link below to learn more about these performance measures.

AADV

OHI

SEA

ADD

Oral Healthcare Tips for PCPS

PCPs also play a vital role in oral health.  Click here to learn about talking points with parents, dental referrals, fluoride varnish, and the importance of oral health care during pregnancy.

Smoking Cessation Resource Guide

Refer to this guide for information on covered nicotine replacement medications for Aetna Better Health of Pennsylvania members, contact information for the Aetna Better Health of Pennsylvania Special Needs Unit, as well as additional smoking cessation resources available throughout the state of Pennsylvania.

 

Coming Soon

  • This webinar series offered throughout 2020 will cover key topics such as:
    • Establishing dental homes for our membership
    • Dental Sealants (Dental practitioner focused)
    • ADV HEDIS/CMS measures (Dental practitioner focused)
    • Oral health and its effects on overall health for Medical Providers (emphasis on patients with diabetes, cardiovascular conditions, maternity and children under two)

Dental Practitioner Pay for Quality

Thank you for your dedication to your patients, our membership! Aetna Better Health® of Pennsylvania introduces the 2020 Pay-for-Quality (P4Q) Program to participating dental practitioners in Pennsylvania who perform recommended preventive services for key dental performance measures

Dental P4Q Letter

 

Become a certified tobacco cessation counselor 

The Pennsylvania Department of Health (DOH) maintains an online statewide listing of tobacco cessation counseling services. To be listed on the registry, providers are required to apply to DOH and complete Every Smoker, Every Time training program. Providers will receive a Certificate of Completion that must be included with their completed registry application.

  • If you have any questions about this new code or associated requirements providers can contact the Provider Services team (providerservices@skygenusa.com).

How to complete the State-wide Approved Tobacco Cessation Registry 

  1. Complete Every Smoker, Every Time training program. (https://www.health.pa.gov/topics/programs/tobacco/Pages/Registry.aspx) (45 minutes)
  2. Complete the Pre-Approved Tobacco Cessation Registry Application (1 page)
  3. Send certificate from Every Smoker, Every Time, and completed registry application to
    1. Please note, a copy of both must be sent to the SKYGEN USA Provider Services team (providerservices@skygenusa.com).

 

Certificate and Completed Application should be sent to: 

                             Bureau of Health Promotion and Risk Reduction

                             Division of Tobacco Prevention and Control

                             625 Forster Street, Room 1032, Health and Welfare Building

                             Harrisburg, PA 17120

 

  • Questions: Call the Division of Tobacco Prevention and Control at 717-783-6600.