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Dental Benefit Management

Express Scripts Canada’s dental experts evaluate the suggested fee guides published annually by the Canadian Dental Association to provide high quality, cost-effective coverage recommendations.

Our solutions help plan providers manage the costs associated with the dental benefit, enabling employers to sustain high quality, cost-effective coverage by:

Providing expertise

Our dental consultants are licensed dentists who stay informed of changes to provincial legislation as well as industry trends and issues. They’re available to help our clients with complex claim issues whenever needed.

Offering comprehensive dental reporting

Express Scripts Canada’s reports provide valuable information to help our clients manage dental benefits. Reports are available on demand, through a web-based reports menu. Productivity Reports are intended to help our clients manage their day-to-day business and address processor productivity and claims processing turnaround; our Standard Reports help our clients monitor claim experience and make plan changes as needed.

Ensuring the integrity and accuracy of the data in the claims system

Express Scripts Canada’s Audit Programs verify that claims are paid for authorized procedures only, and in conjunction with plan and fee guide parameters. Our clients receive a comprehensive audit program report once each year.

Maintaining a comprehensive database

Our database includes more than 17,000 dental providers, including their unique identifiers, addresses, specialties and language preference. This database includes dental providers who submit using either electronic data interchange or paper claims, and who practice out of different office locations. Express Scripts Canada pays dental professionals twice monthly for the assigned claims they submit, and provides a detailed claims statement.

To report fraud, click here.

Express Scripts Canada