Ontario dental fees have been climbing annually, and 2019 is no exception. This year, the rates set by the Ontario Dental Association will increase by 4.19%. Dentists use the Provincial Dental Fee Guide to determine the rates they charge for services, while insurers use them as a guideline for “Reasonable and Customary” limits to ensure dentists aren’t overcharging to get a bigger insurance payout.
So, what does this year’s rate increase mean for insurance claims?
The Future of Dental Fees
The steep increase to the Fee Guide this year is likely indicative of what’s to come in the future. The Ontario Dental Association explains that part of the jump in rates is thanks to new infection and prevention control regulations, requiring dental practices to upgrade office equipment and processes, thus increasing operating costs. It seems this is only the start, and next year could hold similar increases to the rates outlined in the Provincial Dental Fee Guide.
Trends show that plan members are also visiting the dentist more often and receiving more services, further contributing to the growing cost of dental claims.
Combatting Rising Dental Claim Costs
The best ways to manage the inevitable increase in dental claim costs are through smart benefits plan design and employee education.
Using healthcare spending accounts (HCSA) is one strategy to encourage employees to shop around for the best price on dental services. For example, if members are given $1,200 in a HCSA, the responsibility is on them to maximize the services and treatments they can receive with that amount.
Using prior year fee guides is another way to keep costs down. Employers can choose ‘current less one’ so that they are always limiting claims to the reasonable and customary amounts of last year, or even two to three years prior.
Educating plan members is another way to ensure benefits plans are being used as efficiently as possible. Topics can include what their dental coverage includes, how to use their plans, and how overuse and misuse can increase costs for all parties.
These strategies will discourage misuse of benefits and encourage plan members to shop around for the best value.
The Benefits Trust helps employers build a better benefits plan than they can get anywhere else. Contact us today.
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