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question about dental insurance?

My dentist siad he couldn't get any money from Aetna because my plan is DMO. Is it possible? The dentist clean my teeth and do the other work and I even don't need to pay copayment. Why the dentist accept this plan if they can't get any money from insurance company? HE IS MY PRIMARY CARE DENTIST. Maybe he really can't get money for my case but he get a paycheck from Aetna once a month. He works for Aetna?!

Public Comments

1. You must have misunderstood. Of course the dentist gets paid by Aetna if you are part of the Aetna DMO insurance plan. That's exactly what the plan does -- it pays the dentist for whatever treatments he gives you that are covered under the plan.
2. Maybe he said he won't get MUCH money...he'll definitely receive less through the plan than if you don't use insurance.
3. A DMO (Dental Maintenance Organization) is similar to an HMO (Health Maintenance Organization). When you sign up, you choose a primary care dentist. If the dentist is not your primary care dentist, his services are not covered. He is not required to tell you that he is not part of the network. That is your responsibility prior to having services. EDIT:If he is in the DMO network and listed as a primary care dentist with Aetna, you need to talk to Aetna about what he is telling you. If they have denied his claim, you should have also received the EOB and denial. Do not simply take his word for it.
4. If he's not in network, and you didn't select him as your service provider, he isn't getting paid. YOU have to set it up, that he gets paid. He only gets paid $10 a month by Aetna, for each patient who signed up UNDER HIM. An analogy here. Your employer pays you. I want you to come over to my house, and paint it. Next week would be great. It shouldn't be a problem, because you're getting paid by your employer!!! Right? Wrong. You only want to work for the guy paying you. He only wants to work for the guys paying HIM.