1997 ended with a decision by the Alberta Dental Association to no longer offer a fee guide to its dentist members. This took effect in January 1998. The suggested fee guide was a guideline by which many dentists based their fees, and by which dental insurance companies based reimbursement coverage for their clients.
Starting in 1998, dental offices across Alberta have started to re-evaluate their practices and the services they offer in order to determine their fees.
Insurance companies have also had to re-evaluate what they will reimburse to their clients. Our observation over the last few years indicates significant changes by insurance companies themselves, as companies try to reduce costs. An example would be the examination appointments changing from 6 months to 9 months to 12 months or longer. Our experience is that each patient is an individual; where some can have 1 year re-care appointments, others need 3-month appointments for their preventive care. For children, we recommend visits twice yearly. Some companies reimburse fees at a percentage, or they use a previous year's fees. All of these changes are making it continually more difficult to manage collection from insurance companies.
So have employers been re-evaluating what benefit plans to purchase for their employees. There are literally hundreds of plans available. Your employer decides how much it wishes to pay for benefits and chooses a plan that tries to meet as many of its employees' needs as possible. The range of benefits depends on what the purchaser wishes to offer employees or members. Some plans may cover as little as 30%, or as much as 100% of dental services, with most falling in the 50% to 80% range. Some plans exclude certain types of services, such as orthodontics, while other plans will cover a full range of dental services. Another variable is the fees they cover. They also vary from one insurance company to the next. When the plans say they cover 80%, they mean 80% of the fees set forth in the "Fee Guide" THEY use. Different insurance companies use different fee guides, and the fees they use for reimbursement are based on an assumption that all dentists are the same, and all patients' needs are the same. And as a consumer, you know that that's not so. So when your dental plan says they cover 80%, they may fall short of their promises.
When you come to our office, we will provide you with a dental treatment plan and estimate that is based on YOUR needs and desires, not those arbitrarily decided upon by your dental plan. The fee will be based mainly on the time required for each procedure and the degree of difficulty involved. "Rushing" it along is not an option for us, since your comfort and the ultimate treatment result, would both be compromised.
At Campbell Dental Centre we understand the importance of dental insurance and the benefits it has provided for you and your family. Dental insurance coupled with the advances in prevention, improved science and technology, better skills and higher training, has created an unprecedented improvement in Canada's overall dental health, more than at any other time in our history.
You are our patient and we care about you. We are going to help you get the best value for your money and the maximum benefit from your insurance. We ARE working for YOU. Contact us for more information.