Latest news with #CanadianDentalAssociation
Yahoo
3 days ago
- Health
- Yahoo
Half of requests for complex dental work are being rejected under national insurance plan
As federal dental care expands to cover most uninsured Canadians, providers say some procedures are being bogged down by paperwork and processing delays. Health Canada says 52 per cent of requests for pre-authorized dental work between November 2024 and June 2025 have been rejected. While the vast majority of claims don't need pre-authorization, it's required for more complex and often more expensive procedures, like crowns or partial dentures. Clinics must submit extra documentation like X-rays and dental charts to show the work is medically necessary before it can be covered and completed. "There's been a lot of confusion for dentists who send in what we would normally send in to a private plan, and it comes back rejected," said Dr. Bruce Ward, a Vancouver dentist and president of the Canadian Dental Association. "It's a much, much, much higher rejection rate than private plans." The multibillion-dollar Canadian Dental Care Plan helps cover the cost of dental work for Canadian residents with a family income below $90,000 who don't have access to private insurance. The program fully expanded to cover people aged 18 to 64 last month. Health Canada says 5.2 million people have been approved for coverage so far, but only about half — 2.2 million — have received care. And some new patients are getting an unexpected bill, while certain parts of the country are struggling to keep up with a huge influx of appointments, Ward said. Still, providers told CBC News the program is providing Canadians much-needed access to care — and that issues with the program are improving. Clinics submit the pre-authorizations through Sun Life, the insurance provider that the federal government contracted to run the program. Dental offices are sometimes waiting weeks or months for a response, only to be told Sun Life needs additional documentation — further slowing down the process, Ward said. "A lot of people have been waiting for crowns to be pre-authorized," Ward said. "There was an avalanche of approvals that got sent in." Health Canada said rejections and delays in pre-authorizations are caused by several factors, including an unexpected high volume of submissions that were missing information. Oral health-care providers also tell CBC News there were many technical issues with the submission software that have since been largely resolved. Health Canada has worked to streamline the process and educate providers about how to complete the applications, a spokesperson said. Eighty per cent of the pre-authorizations are now being processed within seven business days. And more than 90 per cent of the claims, like basic cleanings or fillings, don't require pre-authorization. But Donna Wells, manager of professional practice at the Canadian Dental Hygienists Association, said the program needs to better cover preventive care. The plan currently allots one hour of scaling per year for adults. Teenagers get just 15 minutes of scaling. "These are patients who have not had oral health care, in some cases, for a number of years, because it's been such a financial barrier for them," Wells said. She said pre-authorization applications for additional scaling are being rejected en masse. Health Canada says over a million Canadians signed on to the program when it expanded in June, and 94,980 of them received dental care. But that influx of patients has led to a backlog in some parts of the country, like Atlantic Canada."This program is wonderful, but it's putting a strain on providers," said Natalie Marsh, a dental assistant in North Sydney, N.S., and vice-president of the Canadian Dental Assistants Association. She said her clinic is already booking appointments for spring 2026. "You're seeing people who haven't seen a dentist in a long time. So they're coming in with a lot of work to be done," she said. Providers said patients continue to be under the impression their dental work will be free of charge. But the program reimburses clinics at a rate lower than provincial fee guides, which they often use to set their rates. That means dental offices can "balance bill," charging the difference between the price of the procedure and what Ottawa will pay them. "I just had somebody in my office a couple of weeks ago who was very upset, because they'd been told that they were covered 100 per cent," Ward said. Ward said patients, including seniors, should remember they need to reapply every year. Despite those challenges, Ward said overall he's found the dental care plan to be "very good" to work with. That sentiment is echoed by other oral health associations. "It's been a huge boon to a lot of people who frankly would never have been able to afford to have their mouths taken care of," Ward said. "It's remarkable," he said. "And yes, there's going to be some growing pains."
Yahoo
3 days ago
- Health
- Yahoo
Half of requests for complex dental work are being rejected under national insurance plan
As federal dental care expands to cover most uninsured Canadians, providers say some procedures are being bogged down by paperwork and processing delays. Health Canada says 52 per cent of requests for pre-authorized dental work between November 2024 and June 2025 have been rejected. While the vast majority of claims don't need pre-authorization, it's required for more complex and often more expensive procedures, like crowns or partial dentures. Clinics must submit extra documentation like X-rays and dental charts to show the work is medically necessary before it can be covered and completed. "There's been a lot of confusion for dentists who send in what we would normally send in to a private plan, and it comes back rejected," said Dr. Bruce Ward, a Vancouver dentist and president of the Canadian Dental Association. "It's a much, much, much higher rejection rate than private plans." The multibillion-dollar Canadian Dental Care Plan helps cover the cost of dental work for Canadian residents with a family income below $90,000 who don't have access to private insurance. The program fully expanded to cover people aged 18 to 64 last month. Health Canada says 5.2 million people have been approved for coverage so far, but only about half — 2.2 million — have received care. And some new patients are getting an unexpected bill, while certain parts of the country are struggling to keep up with a huge influx of appointments, Ward said. Still, providers told CBC News the program is providing Canadians much-needed access to care — and that issues with the program are improving. Clinics submit the pre-authorizations through Sun Life, the insurance provider that the federal government contracted to run the program. Dental offices are sometimes waiting weeks or months for a response, only to be told Sun Life needs additional documentation — further slowing down the process, Ward said. "A lot of people have been waiting for crowns to be pre-authorized," Ward said. "There was an avalanche of approvals that got sent in." Health Canada said rejections and delays in pre-authorizations are caused by several factors, including an unexpected high volume of submissions that were missing information. Oral health-care providers also tell CBC News there were many technical issues with the submission software that have since been largely resolved. Health Canada has worked to streamline the process and educate providers about how to complete the applications, a spokesperson said. Eighty per cent of the pre-authorizations are now being processed within seven business days. And more than 90 per cent of the claims, like basic cleanings or fillings, don't require pre-authorization. But Donna Wells, manager of professional practice at the Canadian Dental Hygienists Association, said the program needs to better cover preventive care. The plan currently allots one hour of scaling per year for adults. Teenagers get just 15 minutes of scaling. "These are patients who have not had oral health care, in some cases, for a number of years, because it's been such a financial barrier for them," Wells said. She said pre-authorization applications for additional scaling are being rejected en masse. Health Canada says over a million Canadians signed on to the program when it expanded in June, and 94,980 of them received dental care. But that influx of patients has led to a backlog in some parts of the country, like Atlantic Canada."This program is wonderful, but it's putting a strain on providers," said Natalie Marsh, a dental assistant in North Sydney, N.S., and vice-president of the Canadian Dental Assistants Association. She said her clinic is already booking appointments for spring 2026. "You're seeing people who haven't seen a dentist in a long time. So they're coming in with a lot of work to be done," she said. Providers said patients continue to be under the impression their dental work will be free of charge. But the program reimburses clinics at a rate lower than provincial fee guides, which they often use to set their rates. That means dental offices can "balance bill," charging the difference between the price of the procedure and what Ottawa will pay them. "I just had somebody in my office a couple of weeks ago who was very upset, because they'd been told that they were covered 100 per cent," Ward said. Ward said patients, including seniors, should remember they need to reapply every year. Despite those challenges, Ward said overall he's found the dental care plan to be "very good" to work with. That sentiment is echoed by other oral health associations. "It's been a huge boon to a lot of people who frankly would never have been able to afford to have their mouths taken care of," Ward said. "It's remarkable," he said. "And yes, there's going to be some growing pains."
CBC
3 days ago
- Health
- CBC
Half of requests for complex dental work are being rejected under national insurance plan
Social Sharing As federal dental care expands to cover most uninsured Canadians, providers say some procedures are being bogged down by paperwork and processing delays. Health Canada says 52 per cent of requests for pre-authorized dental work between November 2024 and June 2025 have been rejected. While the vast majority of claims don't need pre-authorization, it's required for more complex and often more expensive procedures, like crowns or partial dentures. Clinics must submit extra documentation like X-rays and dental charts to show the work is medically necessary before it can be covered and completed. "There's been a lot of confusion for dentists who send in what we would normally send in to a private plan, and it comes back rejected," said Dr. Bruce Ward, a Vancouver dentist and president of the Canadian Dental Association. "It's a much, much, much higher rejection rate than private plans." The multibillion-dollar Canadian Dental Care Plan helps cover the cost of dental work for Canadian residents with a family income below $90,000 who don't have access to private insurance. The program fully expanded to cover people aged 18 to 64 last month. Health Canada says 5.2 million people have been approved for coverage so far, but only about half — 2.2 million — have received care. And some new patients are getting an unexpected bill, while certain parts of the country are struggling to keep up with a huge influx of appointments, Ward said. Still, providers told CBC News the program is providing Canadians much-needed access to care — and that issues with the program are improving. Missing information Clinics submit the pre-authorizations through Sun Life, the insurance provider that the federal government contracted to run the program. Dental offices are sometimes waiting weeks or months for a response, only to be told Sun Life needs additional documentation — further slowing down the process, Ward said. "A lot of people have been waiting for crowns to be pre-authorized," Ward said. "There was an avalanche of approvals that got sent in." Health Canada said rejections and delays in pre-authorizations are caused by several factors, including an unexpected high volume of submissions that were missing information. Oral health-care providers also tell CBC News there were many technical issues with the submission software that have since been largely resolved. Health Canada has worked to streamline the process and educate providers about how to complete the applications, a spokesperson said. Eighty per cent of the pre-authorizations are now being processed within seven business days. And more than 90 per cent of the claims, like basic cleanings or fillings, don't require pre-authorization. But Donna Wells, manager of professional practice at the Canadian Dental Hygienists Association, said the program needs to better cover preventive care. The plan currently allots one hour of scaling per year for adults. Teenagers get just 15 minutes of scaling. "These are patients who have not had oral health care, in some cases, for a number of years, because it's been such a financial barrier for them," Wells said. She said pre-authorization applications for additional scaling are being rejected en masse. Growing pains Health Canada says over a million Canadians signed on to the program when it expanded in June, and 94,980 of them received dental care. But that influx of patients has led to a backlog in some parts of the country, like Atlantic Canada. WATCH | From May 2024: Dental care program begins: First phase of Canada's national dental care plan begins 1 year ago Duration 2:02 "This program is wonderful, but it's putting a strain on providers," said Natalie Marsh, a dental assistant in North Sydney, N.S., and vice-president of the Canadian Dental Assistants Association. She said her clinic is already booking appointments for spring 2026. "You're seeing people who haven't seen a dentist in a long time. So they're coming in with a lot of work to be done," she said. Not a 'free' program Providers said patients continue to be under the impression their dental work will be free of charge. But the program reimburses clinics at a rate lower than provincial fee guides, which they often use to set their rates. That means dental offices can "balance bill," charging the difference between the price of the procedure and what Ottawa will pay them. "I just had somebody in my office a couple of weeks ago who was very upset, because they'd been told that they were covered 100 per cent," Ward said. Ward said patients, including seniors, should remember they need to reapply every year. Despite those challenges, Ward said overall he's found the dental care plan to be "very good" to work with. That sentiment is echoed by other oral health associations. "It's been a huge boon to a lot of people who frankly would never have been able to afford to have their mouths taken care of," Ward said.
Hamilton Spectator
18-06-2025
- Health
- Hamilton Spectator
Dental hygienists association says reports of worker shortage is ‘misinformation'
The Canadian Dental Hygienists Association is calling recent reports of a labour shortage in their profession 'misinformation.' The association's chief executive officer Ondina Love said Tuesday that the workforce is stable, but that many dental hygienists are driven out by poor working conditions, inadequate pay and burnout. The industry group told a morning press conference in Ottawa that retention is the issue that urgently needs to be addressed as Canada's federal dental plan expands and increases demand. 'We must correct the narrative. Claims of widespread dental hygienist shortages are often exaggerated and unsupported. Let me be clear, such assertions are unverifiable and false,' said Love. Back in March, the Canadian Dental Association, which represents 21,000 dentists, prepared a policy platform ahead of the federal election that said many of its members faced an ongoing shortage of dental hygienists. After the hygienists' press conference Tuesday, the association said in an emailed statement that it's important for hygienists to work in supportive environments, and said that it collaborated with the hygienists' association in 2022 to improve mental-health and human-resource support. But the dentists' group also repeated its concern about staffing levels, saying it is 'among the most pressing issues impacting dental office's ability to provide care.' Love said her association's data shows 25 per cent of dental hygienists will likely leave the profession within five years, but that the number of new graduates exceeds that. She said the issue is about retention and not a shortage. She pointed to a survey of more than 2,900 association members in 2023 that found 40 per cent considered leaving their jobs, and six in 10 reported experiencing or witnessing bullying, abuse and violence at work. Love said complaints of a shortage mostly come from organizations representing dentists, who are often hygienists' employers. She said that includes a petition signed by more than 670 dentists in Ontario calling on the province to allow internationally trained dentists to clean and polish teeth. In a federal election policy platform released in March, the Canadian Dental Association said an 'ongoing shortage' was already limiting care and estimated that the country will need more than 1,500 additional dental hygienists to meet an expected influx of patients newly covered by the Canadian Dental Care Plan. The federal government says more than four million people have been approved for coverage since the plan began in May 2024, and that a total of nine million Canadians are expected to be eligible. Applications for people aged 18 to 64 opened in May and coverage for those who are eligible began earlier this month. On Tuesday, the dentists' group pointed to Statistics Canada data that found 50 per cent of dental offices reported difficulty recruiting hygienists in 2023. 'A growing population and increased demand for dental services have created significant operational challenges for dental practices,' the Canadian Dental Association said. Donna Wells, the hygienist association's manager of professional practice, said dental hygiene programs have increased their cohort sizes and the current number of graduates offsets the number of people leaving the profession. 'We want to ensure that dental hygienists who are already in the profession stay in the profession. And I think that needs to be addressed,' Wells said. She said the number of dental hygienists vary by region, with far less in some rural and remote areas, but pushes back on those who say there is an overall shortage. The Canadian Dental Hygienists Association is calling on the Canadian Dental Association to collaborate on an oral health workforce strategy to improve working conditions and equitable distribution of oral health professionals across the country. Many dental hygienists work at dentist-owned clinics but a growing number work at independent dental hygienist offices that operate without the presence of a dentist. To practise in Canada, they must be registered or licensed by a provincial or territorial regulatory authority. This report by The Canadian Press was first published June 17, 2025. Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Winnipeg Free Press
17-06-2025
- Health
- Winnipeg Free Press
Dental hygienists association says reports of worker shortage is ‘misinformation'
The Canadian Dental Hygienists Association is calling recent reports of a labour shortage in their profession 'misinformation.' The association's chief executive officer Ondina Love said Tuesday that the workforce is stable, but that many dental hygienists are driven out by poor working conditions, inadequate pay and burnout. The industry group told a morning press conference in Ottawa that retention is the issue that urgently needs to be addressed as Canada's federal dental plan expands and increases demand. 'We must correct the narrative. Claims of widespread dental hygienist shortages are often exaggerated and unsupported. Let me be clear, such assertions are unverifiable and false,' said Love. Back in March, the Canadian Dental Association, which represents 21,000 dentists, prepared a policy platform ahead of the federal election that said many of its members faced an ongoing shortage of dental hygienists. After the hygienists' press conference Tuesday, the association said in an emailed statement that it's important for hygienists to work in supportive environments, and said that it collaborated with the hygienists' association in 2022 to improve mental-health and human-resource support. But the dentists' group also repeated its concern about staffing levels, saying it is 'among the most pressing issues impacting dental office's ability to provide care.' Love said her association's data shows 25 per cent of dental hygienists will likely leave the profession within five years, but that the number of new graduates exceeds that. She said the issue is about retention and not a shortage. She pointed to a survey of more than 2,900 association members in 2023 that found 40 per cent considered leaving their jobs, and six in 10 reported experiencing or witnessing bullying, abuse and violence at work. Love said complaints of a shortage mostly come from organizations representing dentists, who are often hygienists' employers. She said that includes a petition signed by more than 670 dentists in Ontario calling on the province to allow internationally trained dentists to clean and polish teeth. In a federal election policy platform released in March, the Canadian Dental Association said an 'ongoing shortage' was already limiting care and estimated that the country will need more than 1,500 additional dental hygienists to meet an expected influx of patients newly covered by the Canadian Dental Care Plan. The federal government says more than four million people have been approved for coverage since the plan began in May 2024, and that a total of nine million Canadians are expected to be eligible. Applications for people aged 18 to 64 opened in May and coverage for those who are eligible began earlier this month. On Tuesday, the dentists' group pointed to Statistics Canada data that found 50 per cent of dental offices reported difficulty recruiting hygienists in 2023. 'A growing population and increased demand for dental services have created significant operational challenges for dental practices,' the Canadian Dental Association said. Donna Wells, the hygienist association's manager of professional practice, said dental hygiene programs have increased their cohort sizes and the current number of graduates offsets the number of people leaving the profession. 'We want to ensure that dental hygienists who are already in the profession stay in the profession. And I think that needs to be addressed,' Wells said. She said the number of dental hygienists vary by region, with far less in some rural and remote areas, but pushes back on those who say there is an overall shortage. The Canadian Dental Hygienists Association is calling on the Canadian Dental Association to collaborate on an oral health workforce strategy to improve working conditions and equitable distribution of oral health professionals across the country. Many dental hygienists work at dentist-owned clinics but a growing number work at independent dental hygienist offices that operate without the presence of a dentist. To practise in Canada, they must be registered or licensed by a provincial or territorial regulatory authority. This report by The Canadian Press was first published June 17, 2025. Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
