Alberta releases dental fee guide
In mid-August, the Alberta Dental Association and College (ADAC) released a dental fee guide, effective September 1, 2017. After 20 years without a provincial dental fee guide, the newly released document has been criticized for only including a minor two to three percent decrease in fees compared to what Alberta dentists typically charged earlier in 2017. In a statement, Canadian Life and Health Insurance Association President and CEO Stephen Frank said “more work needs to be done to bring fees down to reasonable levels, given that dental fees in Alberta are 26 to 32 per cent higher than elsewhere in the country”. The Alberta Minister of Health has been in contact with ADAC since the fee guide was released and discussions are ongoing regarding further revisions and cost reductions.
Every other Canadian provincial dental association publishes a fee guide which is updated annually. The Alberta Dental Association discontinued publishing a provincial dental fee guide in 1997. At the time, the fee guide was criticized as ‘price fixing’ and it was suggested that it limited competition amongst dental providers. Since then, insurers processing claims have created their own fee guides for Alberta to use as the basis for reimbursement. For example, Manulife’s dental reimbursement values are based on its block of Alberta claims data and are designed so that approximately 70% of submitted claims are eligible for full reimbursement.
While a dental fee guide being established in Alberta is generally good news for plan sponsors, this first edition will result in negligible savings at best. Insurers are expected to base Alberta dental claim reimbursements on the new fee guide effective September 1, 2017. Most group benefits contracts stipulate that reimbursements are made according to the current year’s dental fee guide, though some plan sponsors may have other contractual arrangements.
It remains to be seen when more significant reductions to the Alberta dental fee guide will take place. For the time being, plan sponsors with Alberta employees should expect dental costs to remain above the level in other provinces. It is important to note that fee guides are recommendations and dental offices are not obligated to follow the suggested fees.