New Brunswick Dental Fee Guide
The amount your dentist may charge you and the amount your dental plan may reimburse you for might be different because these two prices are not derived in the same way. When your insurance provider determines the amount of money your dental plan will pay for services covered under the plan, they consider the specific circumstances. On the other hand, every dentist sets their own fees, considering the factors affecting both the practice and the patients served. Operating costs will vary between dental offices as well as provincially. But since 2016, fixed dental fee guides are being introduced in all the states and provinces of Canada to bring about a standardized pricing pattern.
Each province and territory in Canada has a Dental Association. One of the functions of each of these Dental Associations is to give guidance to dentists about dentist prices by publishing Dentist Fee Guides. Dental benefits are based upon the usual and customary charges, up to the New Brunswick Dental Fee Guide for general practitioners. Dental coverage is not adjusted automatically to reflect the current Fee Guide. Revisions to coverage must be approved and are usually accompanied by a corresponding rate increase.
Fee guides are really there to protect you. Many dentists only charge up to the amount suggested by that year’s fee guide, keeping their prices competitive and saving you from paying more out of pocket. If you ever have to switch dentists, be sure to ask your potential new dental office how they charge for services and if their charges align with the fee guide.
What is the Suggested Fee Guide in New Brunswick?
The New Brunswick Dental Society (NBDS) produces an annual suggested fee guide for dentists in New Brunswick. This document outlines over 1,400 dental codes and code descriptors related to specific elements of dental treatment. It also provides suggested fees that serve as a guide only; dentists must not follow the guide or any fee schedule. Many dental plan carriers will base plan coverage on fees and codes within this guide. In some cases, the coverage is based on the previous year's guides (going back a year or more). Every dental code also has a suggested fee. Dentists can charge whatever they want for their services, but there are standards. A dental fee guide gives the most reasonable and customary rate for every dental code. These fee guides get updated every year. Your insurance plan may state that it pays according to this year’s fee guide, meaning your claims will be paid based on those suggested fees. Again, your dentist can charge whatever they like, but your plan will only pay up to the fee guide amount for each code.
Note: Dental plan providers do not work with the NBDS to develop the guide.
What Are Dental Codes?
Every procedure, every appliance, and every exam has a specific code. For example, you may have had a recall exam, where your dentist checks for cavities; some scaling, where the hygienist scrapes plaque off your teeth; and some polishing. These are dental codes that are found in your province’s dental fee guide. Dentists use these codes to record how long they spent cleaning or which type of filling they used.
It may seem mysterious, but every line denotes a specific service, and it’s kind of neat to see your visit translated into different codes.
Note that not all procedures are listed as professional fees. These services’ cost varies based on the associated lab costs and depends upon the complexity of the treatment required. We encourage you to call our office to arrange a visit with one of our dentists to evaluate your oral health and your teeth’ condition so that we can provide a more accurate estimate.
How do Dental Fees Work?
Each province has its own fee guide. Province to province, some of the codes are the same, but New Brunswick has distinctly different codes than Ontario or British Columbia. Some plans may even state that they will pay according to a specific province’s fee guide. For example, if you live in New Brunswick, but your dentist is in Ontario, your claim may only pay according to New Brunswick's fee guide. This doesn’t mean that you have to stop seeing your dentist in Ontario; it just means that your claim will be converted to New Brunswick's codes, eligible at New Brunswick rates.
Benefits of the Dental Fee Guide in New Brunswick
Standard Cost of Dental Procedures
Setting a dental fee guide aims to bring fees more in line with other provinces in the years ahead. In order to make dental procedures affordable for most people living in the province, a standard fee guide is introduced. Although dentists don’t necessarily have to follow the guide, it still references dentists for pricing their services.
Increased Transparency of Dental Care
There are several dentists in New Brunswick, and each one of them prices their dental procedures differently. Not many dentists are happy to share the reason for pricing their services too high. In order to prevent overpricing dental services, dental fee guides are introduced in provinces and reviewed annually. Dental fee guides increase transparency, which encourages competition and reins in costs over time.
Room for Negotiation for Dentists
The fees in the dental guide are recommended but are not mandatory. Dentists continue to set the fees they charge for services. Some will charge more than the fee guide; some will charge less. If dentists disagree with a specific pricing pattern, they can work on the set fees and develop their own pricing way.
Better Fee Understanding for Customers
Another benefit that a fixed dental fee guide has is for customers. Fixed pricing helps people to understand what to expect from various dentists in their region. As mentioned above, dentists can decide their services’ prices; customers will still have a basic idea of various dental procedures may cost. And then, there will be just a little more amount apart from the standard pricing depending on which dentist they choose to visit.
Like dentists and hygienists, dental specialists have their own separate fee guide. Periodontists, endodontists, oral surgeons, and others have codes listed in specialist fee guides. These codes are usually quite different from the regular provincial fee guides. So it is always better to ask the professional about their fees so that you visit someone who fits within your budget.
The cost of treatment should never prevent you from getting the dental care you need. Untreated dental issues can progress to more serious problems like gum disease and other health issues. In some cases, avoiding treatment can end up costing more. Remember that as a dental patient, you have the right to:
We are here to answer all your questions about the dental fee guide in New Brunswick year after year and provide dental care at reasonable rates. We are willing to discuss fees, answer questions, and explain the cost of your treatment. All you have to do is get in touch with us and take things ahead.
Frequently Asked Questions
1. Where can I get a copy of the fee guide?
A print copy of the suggested fee guide can be found in main public libraries (PDF) - this is the same print copy sent to all dentists in New Brunswick. The NBDS does not produce an electronic version of the fee guide for the public or its members. If you have questions related to a specific code, you can inquire with your dentist directly.
2. Are dentists required to follow the provincial fee guide?
No. While many dentists will follow several fees within the guide, there is no requirement to do so. Dental offices consider several variables when determining costs for their office.
3. Why does my dentist charge more than the provincial fee guide?
There is no requirement for dentists to charge the suggested fees outlined in the dental fee guides. Dentists determine costs for their office based on the factors influencing their individual practice.
4. How to read the Abbreviated Fee Guide?
The abbreviated fee guide comprises a list of common dental procedures along with respective procedure codes and suggested fees.
Note: One Unit of time = 15 minutes, One Half Unit = 7 1/2 minutes
+E refers to additional expense for materials; +L refers to commercial or in-house laboratory costs.
5. Why Do Dentists Provide/Offer Procedures That Are Not Covered?
Dentists are responsible for providing you with the best clinical care and treatment options with your health concerns in mind. Dentists do not know with complete certainty which procedures will be covered. If dentists base their treatment options on the limitations of insurance coverage, they will not be able to provide you with the quality dental care you deserve.