“Lack of clarity”: Dentists criticize new billing changes to Canada Dental Care Plan
The federal government has changed billing for the Canadian Dental Care Plan (CDCP) in an attempt to attract more providers, but the Canadian Dental Association (CDA) says this doesn’t mean all dentists will participate.
On Monday, Ottawa announced that dentists can now provide services to CDCP patients on a claim-by-claim basis without having to formally register for the federal dental insurance plan.
“We have heard that some providers prefer not to formally sign on to the program but would still like to see CDCP patients,” reads a news release from Health Canada.
And starting today, we’re making it easier for oral health providers to treat CDCP patients by allowing them to provide services on a claim-by-claim basis without formally signing up. (2/3) pic.twitter.com/5I8vFii5pJ
— Mark Holland (@markhollandlib) July 8, 2024
To limit out-of-pocket costs for CDCP patients, dentists will need to agree to bill Sun Life directly and accept payment for services covered under the plan, regardless of how they choose to participate.
Once a claim is approved, dental providers will initially be reimbursed by Sun Life within 48 hours, with the aim of moving towards a 24-hour turnaround time, according to the government.
Ottawa says this means Canadians covered by the CDCP can see a dental provider of their choice as long as that provider agrees to bill Sun Life directly.
“We’re making it easier for more Canadian families to access quality dental care. This change reduces out-of-pocket costs for families and speeds up reimbursements, making dental services more accessible and affordable across the country,” said Minister of Veterans Affairs Ginette Petitpas Taylor in a statement. “It’s another concrete step towards fairness for every generation.”
In an email to Daily Hive, the CDA says it acknowledges the government’s efforts in introducing the case-by-case billing option, which “may potentially ease some of the administrative burden and will allow providers to experience the plan.”
However, the dental association says no public plan is perfect.
“Although there have been improvements to the plan, dental offices across the country are facing the added burden of having difficult conversations with patients about the CDCP public misconceptions,” said a spokesperson.
“In fact, recent surveys with dentists show that dental office staff spend on average 50 minutes per day explaining the federal plan to patients.”
The CDA adds that it’s concerned that some patients think they can see any dentist of their choice when that’s not necessarily true.
As of July 8, CDCP patients are no longer restricted to getting dental care from a provider signed up to the plan, but can also see a dentist that will participate in the claim-by-claim billing.
“However, not all dentists may decide to participate in the alternative pathway as it still requires them to accept the CDCP terms and conditions, and not all dentists may do so,” explained the CDA.
“This lack of clarity will leave patients confused and, in some cases, they may be unable to find a dentist to treat them.”
The association also says there are other public misconceptions about the program’s service coverage, co-payment requirements and potential out-of-pocket costs.
“CDA remains committed to working with the federal government to ensure that the CDCP works for all patients and providers.”
Canada Dental Care Plan applications open up
250,000 Canadians have now received care thanks to the Canadian Dental Care Plan!
Our plan is improving health and changing lives. 🇨🇦🦷 pic.twitter.com/87UBUUyJNi
— Mark Holland (@markhollandlib) July 9, 2024
In addition to the billing update, the federal government announced on Tuesday that CDCP applications are opening for two new groups of Canadians.
The phased rollout continues as follows:
- Adults with a valid Disability Tax Credit certificate – Started June 27
- Children under the age of 18 – Started June 27
If you’re eligible, you can apply here.
What does the CDCP cover?
The CDCP says it will help cover various oral healthcare services, which include:
- Preventive services, including scaling (cleaning), polishing, sealants, and fluoride
- Diagnostic services, including examinations and X-rays
- Restorative services, including fillings
- Endodontic services, including root canal treatments
- Prosthodontic services, including complete and partial removable dentures
- Periodontal services, including deep scaling
- Oral surgery services, including extractions
Some of these services will only become available in Fall 2024, and the federal government will provide further updates on this page.