Here is a breakdown of insurance information:
Insurances:
Welfare
HMO, DMO & DHMO
PPO
Welfare:
(First name, last name ID No., DOB)
Welfare insurances need pre-authorization for major procedures
Own Policy holders
Procedures such as fillings, Sealants and Extractions (non surgical) do not need pre-authorization.
Welfare insurance companies include
Keystone Mercy/Keystone first
Aetna Us Healthcare and Health Partners
Americhoice
Amerihealth Mercy/Amerihealth Caritas
Access
Avesis Dental Claims
United Concordia
Union (Welfare)
HMO & DMO:
Patients with these insurances do not need pre-authorization on dental procedures. However, they need to choose us as their primary provider with their insurance company. There is no yearly max and the patient may undergo as many dental procedures as required.
Aetna (DMO starts with ‘W’-9 digits)
HMO (All letters)
Cigna and DHMO (start with ‘U’-8 digits) (Name DOB of the Policy Holder)
UCC I (United Concordia)
(HMO&PPO) (SSN, ID# & DOB)
Deltacare USA (HMO) (ID# or Policy Holder’s SSN)
Dominion Dental Service (HMO)
Keystone Health Plan East (Name DOB od patient and Policy Holder)
Fidelio (Fee Schedule
PPO
(Name & DOB for the Policy Holder SSN or ID#)
Such insurance require pre-authorization.
They have yearly maximum on the amount which the insurance companies will pay towards dental procedures.
Delta
Aetna
Metlife
Cigna
HMO
HMO stands for health maintenance organization. HMOs have their own network of doctors, hospitals and other healthcare providers who have agreed to accept payment at a certain level for any services they provide. This allows the HMO to keep costs in check for its members.
DHMO
Dhmo A dental health maintenance organization, better known as a DHMO, is a type of dental insurance plan. Like a medical HMO, it is a form of managed care. To participate, dental plan members must select a primary care dentist for all nonspecialty services from the insurance company’s provider network. The insurance company sends a monthly payment to the network providers for each patient who has selected them as their primary care dentist. Dentists are not reimbursed for each service
DMO
DMO, or Dental Maintenance Organization, is a dental insurance plan wherein you can only choose dentists who are part of the DMO network you signed up for. Choosing a dentist who isn’t part of the network means you forfeit your right to the coverage that you paid for.
PPO
PPO Insurance Plans. What is a PPO plan? PPO plans, or "Preferred Provider Organization" plans, are one of the most popular types of plans in the Individual and Family market. PPO plans allow you to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.