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The Canadian Dental Care Plan is a dental insurance program funded by the Government of Canada to provide dentistry services to uninsured Canadians that meet certain criteria. [1] It replaces a temporary dental benefit program established in 2022 for children under 12 who did not have dental insurance coverage, which was terminated in June 2024 ...
In addition, payment to dental professionals is based on the CDT code(s) reported on the ADA Claim Form, so using the most current codes helps to maximize reimbursement and minimize audit liability. [6] In the near future, dental professionals will be required to use diagnosis codes in support of the procedures and services they provide.
With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
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Pure IBNR refers to only unreported claims, not any development on reported claims. Incurred but not enough reported (IBNER), in contrast, refers to development on reported claims. For example, when a claim is first reported, a $100 payment might be made, and a $900 case reserve might be established, for a total initial reported amount of $1000.
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