Getting the right processes and products in place for the Canadian Dental Care Plan.
A bright, healthy smile can lift moods, boost confidence, open doors, and improve job prospects. The Canadian Dental Care Plan (CDCP) was introduced to remove the financial barriers to dental care and help more Canadians maintain healthy smiles.
The CDCP covers all or a significant portion of the costs for eligible, uninsured Canadians to receive essential dental services. The program is voluntary for dental practices, and nearly 90% of all active oral healthcare providers are participating.
In this article, we will discuss how the CDCP can affect patient numbers and dental office workflows going forward, as well as how to administer billing and ensure compliance.
How the CDCP can affect patient numbers and dental office workflows
CDCP coverage is helping to increase patient access to dental care across Canada. More than 3 million applicants have been approved so far. With the anticipated influx of patients, dental offices may want to prepare by stocking up on essential dental supplies. Additionally, CDCP coverage is expanding in scope. This will make even more procedures accessible to Canadians, including preauthorized services, such as crowns and procedures that require anesthesia, so the breadth of supplies needed on hand will also grow.
For participating dental offices, everything from inventory management to patient handling to marketing communications and more will need to be adjusted to accommodate CDCP patients. And since the program covers otherwise uninsured patients, additional preauthorization requests will need to be processed for services such as restorative and endodontic procedures.
CDCP program billing and compliance
Oral healthcare providers, including dentists and dental specialists, denturists, and dental schools, are eligible to participate in the CDCP by signing up through Sun Life or submitting on a per-claim basis. While electronic claims have been accepted from the outset, the program has recently expanded to enable paper claims for dental offices that prefer to work with hard copies.
CDCP fees for services have been established, and dental offices need to bill and receive payment through Sun Life. For many patients, treatment will not be fully covered by the CDCP program, so dental offices should verify a patient’s CDCP coverage level and covered services prior to treatment. Patient eligibility can be confirmed by submitting an EDI estimate to Sun Life, accessing the Sun Life Direct lookup tool, or phoning Sun Life’s contact center at 1-888-888-8110.
While Dental offices must bill Sun Life directly for the covered amounts, they must bill patients for any amounts above and beyond those covered by the program. They also have the option to bill patients an additional co-pay should the government-established rates not meet the full cost of a procedure. Additional fees should be communicated to patients before treatment.
Conclusion: Be CDCP-ready with essential dental supplies
The Canadian Dental Care Plan is being rolled out in stages, and its scope will be expanded in 2025 to enable applications from a broader range of Canadian residents. With more patients on the horizon, now may be a good time to speak to your dedicated Frontier Dental sales rep or visit our website to stock up on high-value, cost-effective dental supplies. You will enjoy 30-day payment terms on over 30,000 quality items, with free shipping—no limitations. Your order can even be en route on the day it is placed. Take advantage of our specials, and make sure you have the supplies you need to provide the essential services that keep Canadians smiling.
