There is a tidal wave rolling through the dental community currently asking the question:
What will CDCP do to my bottom line?
The Canadian government has brought in a universal dental plan for non-insured individuals to help deliver dental care to a vulnerable population. They have provided minimal and confusing information to our Provincial Dental Associations, and they have requested that all dental offices sign up as providers for this plan.
It seems that every office is seeking advice as to what to do about the program.
I would love to say yes to free dentistry for all as a public service. The reality is that dentistry is a business with very high overhead.
[What I am providing today is my opinion with current available information as to how to navigate CDCP, this information may change in the future along with the management of CDCP].
Here are six important and relevant insights:
- Only 50% of the general population regularly see a dentist, this number likely won’t change with CDCP. Depending on demographics, most practices have roughly 80% of their patients on some form of dental insurance. Again, this number won’t change as patients can’t opt out of employer insurance and receive CDCP coverage. TIP: Run the report in your software to see how many currently active patients have (any) coverage and how many patients are not insured. If you look at your current active total, you will find your percentage of non- insured patients. This will allow you to see the potential of patients who may be covered by CDCP and therefore, you can make decisions accordingly.
- It is your choice to sign up for the plan or not. There will be many practices who will sign up for the plan and likely even more that don’t. I see the offices that do sign up as practices will most likely be new startups who are looking to grow their patient base. This will occur in areas of market saturation.
[NOTE:]: Dentists – you will need to differentiate your practice through the quality of care and outstanding patient systems and experiences to become the difference between an office that is providing care at less than provincial standard fees to the majority of their patient base.
It is a poor business strategy to build your practice based on the decreased fees from CDCP, you will find yourself cutting corners in too many places to live within the fee structure and you will not be able to keep up in the long run. TIP: If you choose to see patients with coverage from CDCP to keep your overhead in check your office policy should include that fees should be from the provincial fee guide by way of CDCP reimbursement, CDCP co-pay (if applicable) and co-pay to match the provincial fee.
- That said, your Accounts Receivable Protocols will need to be amended to ensure that the administrators in your office are very aware of the rules for your office and the protocols around the collection of either of those copayments. If your office has always been fee-for-service this will require some new protocols around copayments. TIP: All copayments need to be collected at the time of service. The patient’s explanation of benefits will show the totals and office protocol needs to be given to patients so that they will understand that CDCP is a way to help pay for some of their care and they are still responsible for the balance.
- Whether you decide to accept CDCP in your office or not, your team needs to be provided with verbiage for either scenario. Verbiage must be uniform in nature and the entire team needs to be well versed as to your office’s policy. TIP: If you choose to not register for CDCP your verbiage could be “At this time we have not registered for participation in the CDCP plan, we have some concerns that CDCP will impact the level of care that we are able to provide to our patients. If we decide to register for the program, we can certainly let you know. We will continue to deliver outstanding care for all our patients.” If you decide to register for CDCP your verbiage can be “Yes, we are currently participating in the Government Program, this program will not mean that your care is provided at no charge, the Government requires a patient copay for most patients, there will still be a balance to be paid at the time of each appointment.” You can then talk to your patients about how you are handling the balance between CDCP fees, CDCP copay and any office balance.
- If you decide to sign up for CDCP you will notice that there are some limitations similar to the Provincial plans (for example ODSP) on hygiene services. As with ODSP there are only four units of scaling available every twelve months for a patient, yet you can have preauthorization for added scaling units for adults only. The amount of scaling per twelve-month period for a child is also below the standard of care for preventative care. TIP: For an adult at least send in a preauthorization for more units of scaling for almost every patient. For a child there will need to be a lot of parent education to ensure that children are receiving the preventative care they deserve both at home and in the office.
- In the worst case scenario where you find patients leave your practice for a provider who is billing through CDCP, ensure that your administrators are properly inactivating patients and entering the exact reason for inactivation into your software. This way you will be able to quantify any patients who have left for the reason of CDCP, if this number gets too high to become comfortable, you can always decide at a later date to register for CDCP and contact those patients to return.
Whether you are one of the 30% of dentists in Canada who are planning on accepting CDCP or one of the 70% of dentists in Canada who won’t be currently registering, you need to realize that this is a very fluid situation, patients will have many questions and your team needs to be prepared.
I would suggest bringing in a coach to ensure that your systems, protocols and production levels are in tip top shape, it will be money well invested.
