We’re pleased to announce that our office accepts the Canadian Dental Care Plan (CDCP) through the alternative provider pathway as we are not enrolled directly with CDCP.
Below are key details to help you understand how billing works with the CDCP
Fee Guide & Copayments
As a specialist office, we use the Ontario Dental Association Fee Guide for Endodontic Specialists, which is higher than the CDCP’s general dentist fee guide. As a result, a copayment may apply, which is the amount not covered by CDCP.
Why doesn’t CDCP cover my full treatment cost?
CDCP sets reimbursement amounts based on the general dentist fee guide. Our office follows the specialist fee guide (which reflects the advanced training, technology, and expertise of endodontic care), CDCP often does not cover the full fee. The difference between what CDCP pays and our specialist fee becomes your responsibility. This is called a copayment or balanced billing.
What is Balanced Billing?
Balanced billing means we charge our standard specialist fees, and you’re responsible for any portion not covered by CDCP. This helps us maintain the high level of specialty care we provide.
Why do I need an exam if my dentist already diagnosed me?
Even if your dentist has already diagnosed the problem, as a specialist office, we must perform our exam and imaging (such as CBCT) before starting treatment. This ensures we confirm the diagnosis, assess the complexity, and provide the most accurate treatment plan for your case. It is also required for us to submit the claim properly to CDCP.
What is a Clawback?
Sometimes, CDCP may reverse or reduce a payment after it has been processed — this is known as a clawback. If this happens, you will be responsible for paying the outstanding balance.
Before Your Appointment:
- Confirm your CDCP eligibility with Sun Life (1-888-888-8110)
- Bring your CDCP info to your appointment
- Contact us in advance if you’d like a cost estimate
For additional information about CDCP, you can also review the Canadian Dental Association’s FAQ.
Local Care, Clear Answers
River Street Endodontics is a boutique endodontic specialist practice located in Corktown, Toronto. Have CDCP questions? Call or email us today—we’re happy to help you understand your coverage and options.