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Ottawa allows dentists to bill federal program on case-by-case basis

admin, July 9, 2024

As of today, oral health-care providers can treat patients under the Canadian Dental Care Plan on a case-by-case basis without officially signing on to the program.

Ottawa introduced the measure in the hope that it would entice more dentists to take part in the new national public insurance plan.

“You can just try it out, submit a claim and see what you think,” Health Minister Mark Holland told a press conference in Halifax on Monday.

Patients should still check to see whether their dentist is willing to accept them as oral health-care providers decide whether they want to participate, Health Canada officials cautioned.

More than 2 million people are approved for coverage so far under the program, which eventually will help to pay for dental office visits for the one in four low- and middle-income Canadian residents who don’t have private coverage.

To bill on a case-by-case basis, providers must agree to submit claims directly to Sunlife, the insurance company the federal government contracted to run the program. They can’t ask their patients to pay the full cost up front.

“We have certain providers who are handing over Sun Life forms and saying, ‘You go send this in and you go pay for it.'” Holland said. “The patient doesn’t pay out of their own pocket.”

Providers are being reimbursed in as little as 12 hours, he added.

To submit claims on a case-by-case basis, oral health-care providers must also agree to verification of their services, Holland said. This is similar to how private dental plans work, he added.

“We have no interest in auditing anybody unless there is evidence of malfeasance,” Holland said.

WATCH: Health minister defends communications on dental plan

Health minister defends communication on dental plan

A report by the Canadian Dental Association is calling on the federal government to clear up misconceptions about the federal dental care plan. Health Minister Mark Holland says dental offices that opted into the program aren’t experiencing these concerns and encouraged those that haven’t signed on to join the program.

The Canadian Dental Association, which has long advocated for a national public dental care plan, has raised concerns about the program, arguing it requires dentists to agree to terms and conditions with the federal government.

But the number of professionals signing up is growing — 11,800 oral health-care providers have registered for the program, officials said Monday. That’s slightly less than 40 per cent of all providers in the country and includes dentists, independent hygienists, denturists and dental specialists.

The Canadian Dental Care Plan first started covering seniors in May of this year. So far, 250,000 seniors have received care. On June 27, the program expanded to include children under 18 years of age and adults who receive the disability tax credit.

Health Canada officials said Monday that so far they’ve received nearly 10,000 applications for people with disabilities and 25,000 for children.

It can take up to three months to be approved, Health Canada officials said, and applicants should not see their oral health-care provider until they’ve received their insurance information.

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