In the occasion that a member disagrees with a protection dedication, Aetna supplies its members with the best to attraction the decision. However, applicable state mandates will take priority with respect to completely insured plans and self-funded non-ERISA (e.g., authorities, college boards, church) plans. While the Dental Clinical Policy Bulletins are developed to assist in administering plan advantages, they do not represent a description of plan benefits. The Dental Clinical Policy Bulletins describe Aetna’s current determinations of whether or not certain services or provides are medically necessary, based mostly upon a evaluation of accessible clinical information. Each profit plan defines which providers are lined, that are excluded, and which are topic to greenback caps or other limits. Members and their providers will need to consult the member’s benefit plan to determine if there are any exclusions or different benefit limitations applicable to this service or provide.
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