In April, the Non-Insured Health Benefits (NIHB) program launched a voluntary 2-year trial process to include posterior endodontic treatment as basic treatment under the NIHB plan.
At the dentist's choosing, the predetermination requirement can be removed for standard root canal treatment (RCT) procedures on bicuspids and first molars. However, second and third molars continue to require predetermination according to NIHB endodontic policy.
Dentists should remember that this NIHB trial project is purely voluntary. Dentists can choose to continue to submit a predetermination request to their Regional Office, where the submission will be reviewed in accordance with the NIHB endodontic policy.
For those dentists who agree to participate in the trial, the NIHB will randomly contact providers of paid standard RCT cases to request all supporting documentation and radiographs, as outlined in the endodontic policy. Failure to submit the required documentation may result in recoveries.
CDA continues to meet with NIHB officials on a regular basis through a technical working group. In fact, the Association proposed the addition of posterior endodontic treatment as basic treatment under the NIHB plan and worked to secure this 2-year voluntary trial.
For more details on this trial project, see http://www.hc-sc.gc.ca/fniah-spnia/pubs/nihb-ssna/_dent/2011-prov-fourn-guide/index-eng.php#a8.4