Question About Claims and How It Works? (Aetna Health Insurance)

Hi All,

I recently enrolled in dental insurance and I had a question regarding how the entire process works. I am enrolled with Aetna and I’m extremely confused how the dental insurance works.

Overview of situation –

I went ahead and got 2 fillings and 2 deep cleanings scheduled/done. I had separated them into two different appointments but I paid in full upfront before these services were completed and provided. Since this was a dental provided in-network they charged me $166.40 for the total cost of everything. Which i was fine with.

(Edit – I had received / completed these services and received a claim shortly after even though I paid it all off.)

Later I get a notification from Aetna that I have a claim and a “total amount that you may owe of $166.40”. I waited and 2 months later, this amount hasn’t cleared/changed. Is it supposed to clear down to $0 if it’s been fully paid off? If so I have proof but I’m not sure if i should reach back out to the dental office or Aetna to show them proof it’s been paid off.. or is it normal to have claims with balances that don’t need to be zeroed out as long as you truthfully paid it?

I guess i’m confused because I paid out of pocket for something else related to Aetna Health (not dental related) regarding an ear issue I had. This payment shows up as “total amount you may owe of $0” when in reality I paid $233.30 and it showed up for that claim/cleared out successfully.

Should I be worried if the amount on the claim hasn’t changed and it shows up as the full amount I had pay with the status of “Total amount that you may owe of XYZ”?

​

This is the first time I have enrolled in dental insurance. I appreciate all the helpful information !



View Reddit by accountinglover123View Source

Hi All,

I recently enrolled in dental insurance and I had a question regarding how the entire process works. I am enrolled with Aetna and I’m extremely confused how the dental insurance works.

Overview of situation –

I went ahead and got 2 fillings and 2 deep cleanings scheduled/done. I had separated them into two different appointments but I paid in full upfront before these services were completed and provided. Since this was a dental provided in-network they charged me $166.40 for the total cost of everything. Which i was fine with.

(Edit – I had received / completed these services and received a claim shortly after even though I paid it all off.)

Later I get a notification from Aetna that I have a claim and a “total amount that you may owe of $166.40”. I waited and 2 months later, this amount hasn’t cleared/changed. Is it supposed to clear down to $0 if it’s been fully paid off? If so I have proof but I’m not sure if i should reach back out to the dental office or Aetna to show them proof it’s been paid off.. or is it normal to have claims with balances that don’t need to be zeroed out as long as you truthfully paid it?

I guess i’m confused because I paid out of pocket for something else related to Aetna Health (not dental related) regarding an ear issue I had. This payment shows up as “total amount you may owe of $0” when in reality I paid $233.30 and it showed up for that claim/cleared out successfully.

Should I be worried if the amount on the claim hasn’t changed and it shows up as the full amount I had pay with the status of “Total amount that you may owe of XYZ”?

​

This is the first time I have enrolled in dental insurance. I appreciate all the helpful information !



View Reddit by accountinglover123View Source

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