How DMO dental plan works?

I have two dental plans. The primary is metlife PDP, the second one is Aetna DMO. Recently I did an onlay and my dentist is in both networks. The dental office filed a claim to metlife who will pay 50%. While waiting for the EOB from the primary one, I called Aetna to confirm how to file the second claim for the remaing balance. I was told that Aetna pays the dentist monthly fee under DMO plan no matter if we have service or not. But if we do have service, Aetna won't pay any additional fee. Therefore, the dentist or I won't get any payment for this service. This is so confusing. I then called Aetna again and talked to another agent. The answer was totally different. They are saying that they will coordinate with my primary insurance and send a check within their benefit allowance. Which answer is correct? Anyone here familiar with how DMO works? Thanks!
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Dental insurance companies suck! They're in business to keep money in their own pockets. The situation you're in is very common. I owned my own dental practice for 8 years. It can be very difficult to estimate costs for patients' when they have dual insurance. I had lots of problems, where the insurance companies didn't want to pay and the patient didn't want to pay and we all went round and round for months. With my front office manager and the patient getting very upset. I resolved this by anyone who had dual insurance, I only filed the primary and the patient paid me the difference. The patient would then file their secondary claim themselves. When the secondary claim paid, it was paid directly to the patient. When I didn't do it this way problems went on for as long as six months. For your particular situation I would recommend reading the fine print of both of your policies. Keep good notes of everyone you talk to, dates, time, names, etc. Try to talk to supervisors only. If they don't pay and many months go by, you may want to sue.
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