Let’s start off with the most frequently asked question “what is a dental fee guide?” A fee guide is a document that outlines over 1600 dental codes that pertain to regular and specialty dental treatment. This outline includes descriptions as well as suggested fees and serves as a guide only. The majority of dental plan carriers will base their coverage on a specific fee guide, this guide may not be current and dental plans do not work with the Alberta Dental Association & College (ADA & C) to develop their guides.
While dentists within Calgary generally follow the fee guide set out for the public, they are not required to do so. Factors that influence individual practices are what help to determine how offices set their fees. Dentists are governed by the Health Professions Act. This ensures that all practices adhere to strict protocols and regulatory standards, much like hospitals, to provide optimal patient care and safety. Operating like a mini hospital along with other factors such as specialized equipment approved materials, sterilization and safety protocols, trained and license professional staff, external lab fees and practice location all contribute to the everyday overhead costs of running a dental practice. These factors directly impact what an office puts out as their fees.
Fee Guides and Our Practice
At R & A Dentistry we have carefully considered the fee guide and have set our fee appropriately. In the 5 years that we have been in practice we had not raised our fees. At the beginning of 2019 we did increase our fees to better follow the ADA & C fee guide that was released in 2018. Some of those changes resulted in an increase to our current fees in order to stay comparable and competitive within the city.
Most dental benefits only follow a very outdated fee guide which does not take in to account the rise in dental costs, wages, rent and other overhead contributions that each dental clinic faces. When the ADA & C fee guide was released it allowed the public to better understand what their service costs but it didn’t explain the discrepancies within dental benefits packages, which are numerous. For example our fee for polishing is $69, a dental benefit plan may cover 100% of their fee which could be $59, leaving an outstanding balance of $10 that our patient is now responsible for. These amounts may vary by each appointment as it is dependent on what services are completed at each appointment as well as what percentage your dental benefits may cover for that required service and which guide they use to determine coverage.
At our clinic we encourage all of our patients to consider sending estimates so that we can know the cost breakdown ahead of time for your appointments. This can help to alleviate some confusion as well as allow us time to explain the breakdown if there are any further questions. We hope this blog helped to further explain dental fee guides and benefit coverage. Our staff is always willing to help answer any other concerns you may have!