CDA Essentials 2015 • Volume 2 • Issue 5

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10 | Volume 2 Issue 5
CDA at Work
Many dentists will remember when sending
dental claims was a time-consuming, paper-
based process.
Once the patient was billed for treatment, if they had
dental insurance, the dental office would complete
and sign a claim form and the patient would mail the
dental claim form to their insurance provider. The
insurance provider entered the information on the
claim form into their computer systems, adjudicated
the claim and—if there were no errors in the
paperwork and no further clarifications required—
the patient waited up to 8 weeks before receiving a
cheque!
A LOOK BACK
But in 1991, an innovation significantly reduced the
time needed for reimbursement and changed the way
dental offices and patients communicated with insurance
companies from that year forward.
The idea was born in the plainly named CDA committee,
the Third-Party Dental Plans Committee, which was
formed in 1984 in response to criticism that CDA needed to
improve communication between dentists and insurance
companies. The challenge was taken on by the committee’s
founding members: Dr. Toby Gushue from Newfoundland,
Dr. Don Gutkin fromManitoba, Dr. Bill Leggett from
Ontario, and Dr. Don MacFarlane from British Columbia.
At first, the committee’s main goals were to develop a
standard dental claim form (at that time different forms
were used by each insurance company) and develop
a new system that would standardize the way dental
procedures were coded and defined across the country.
Each province had its own set of procedure codes,
which created a complicated and inefficient system of
administration for the bigger insurance companies with
clients in more than one province.
“The provinces did not want to change their systems,” says
Dr. Gushue. “They were happy with their own definitions.”
It took several years of closely working with the provincial
associations and various specialty groups, but a national
system for identifying the dental services provided to
patients, the CDA’s Uniform System of Codes and List of
Services (USC&LS)—now the basis of all fee guides and
code lists—was implemented in 1990.
To hear an interview
with Dr. Toby Gushue
on CDAnet, visit
/2015/04/28/tg-2