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SADA/DENTASA Managed Care Discontent Survey

2026 Managed Care: Scheme Rules, Clinical Protocols & Practitioner/Technician Discontent

Purpose of this Survey
This survey is designed to systematically measure the level of discontent among private dental practitioners and private dental technicians regarding the scheme rules and clinical protocols imposed by managed care companies (medical aids/administrators). Your responses will inform SADA and DENTASA’s engagement strategy with funders and regulators.
Completion time: Approximately 8-10 minutes.
All responses are strictly confidential and will be reported only in aggregate.
Please answer all questions as honestly as possible - your candid input is essential.
Deadline for completion: 30 May 2026
A. PRACTITIONER/TECHNICIAN PROFILE
1.I am completing this survey in the following capacity.
2.In which province is your primary practice or lab located?
3.How many years have you been in practice?
4.What is your primary area of clinical focus?
5.Approximately what percentage of your patients belong to a medical aid/managed care scheme?
6.How many managed care/medical aid plans are you currently contracted with?
B. SCHEME RULES & BENEFIT LIMITS
7.(Rate your level of agreement with the following statements)(Required.)
Strongly Agree/Very Satisfied
Agree/Satisfied
Neutral
Disagree/Dissatisfied
Strongly Disagree/Very Dissatisfied
7.1 The benefit limits set by managed care companies adequately cover the cost of necessary dental treatment.
7.2 Scheme rules are transparent and communicated to practitioners in a timely and understandable manner.
7.3 Managed care benefit structures fairly reflect the complexity and time required to perform procedures.
7.4 Benefit sub-limits (e.g. per-tooth, annual caps) are clinically justifiable.
7.5 Scheme rule changes are introduced with sufficient notice for practitioners to prepare.
7.6 Overall, how satisfied are you with current scheme benefit structures?
8.Which of the following scheme rule issues cause you the MOST frustration? (Select all that apply)
C. CLINICAL PROTOCOLS & TREATMENT CODES
9.(Rate your level of agreement with the following statements)(Required.)
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
9.1 The clinical protocols mandated by managed care companies align with current evidence-based dental practice.
9.2 Scheme-approved treatment codes adequately represent the procedures I perform.
9.3 Managed care protocols allow me sufficient clinical discretion to provide patient-centred treatment.
9.4 Scheme clinical protocols are developed with meaningful input from dental professionals.
9.5 The bundling/unbundling rules applied to dental codes are fair and clinically logical.
10.Have you ever been required to deviate from your clinical judgement due to scheme protocol requirements?
11.If your answer to Q10 is Yes, how frequently does this occur?
12.Please describe a specific instance where a managed care protocol negatively impacted patient care (optional):
D: PRE-AUTHORIZATION PROCESSES
13.How would you rate the overall efficiency of the pre-authorization process?
14.(Rate your level of agreement with the following statements)(Required.)
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
14.1 Pre-authorization requirements cause clinically significant treatment delays for my patients.
14.2 Pre-authorization decisions are made by individuals with adequate dental clinical knowledge.
14.3 The appeals/dispute process for declined pre-authorisations is fair and accessible.
14.4 Pre-authorization processes have caused patients to abandon or postpone necessary treatment.
15.On average, how long does a pre-authorization response take?
E: REIMBURSEMENT RATES & FEE SCHEDULES
16.(Rate your level of agreement with the following statements)(Required.)
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
16.1 Current managed care reimbursement rates cover my practice's cost of delivering treatment.
16.2 The gap between scheme tariffs and the cost of delivering treatment has worsened over the past 5 years.
16.3 Fee increases offered by managed care companies keep pace with dental practice inflation (staff, materials, equipment).
16.4 Low reimbursement rates have led you to consider terminating your managed care contract.
17.What is the approximate percentage gap between your private fee and the scheme rate you receive on average?
F: ADMINISTRATIVE BURDEN
18.(Rate your level of agreement with the following statements)(Required.)
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
18.1 The administrative requirements of managed care companies are proportionate and reasonable.
18.2 Managed care administrative demands have required me to employ additional non-clinical staff.
18.3 The audit, profiling and compliance processes imposed by managed care companies are fair and transparent.
18.4 Recovery / clawback demands from schemes have been applied in a procedurally fair manner.
19.Approximately how many hours per week does your practice spend on managed care administration (claims, queries, appeals, authorizations)?
20.Which of the following administrative burdens are most significant? (Select all that apply)
G: PATIENT COMMUNICATION & REFERRALS
21.(Rate your level of agreement with the following statements)(Required.)
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
21.1 Scheme rules make it difficult to communicate clearly with patients about what is covered versus excluded.
21.2 Managed care requirements negatively impact the doctor–patient relationship.
21.3 Patients frequently express frustration about scheme-imposed limitations during consultations.
21.4 Scheme network or referral restrictions limit your ability to refer patients to appropriate specialists.
21.5 Managed care requirements have negatively affected patient outcomes in your practice.
H: OVERALL SENTIMENT & SADA/DENTASA ENGAGEMENT
22.Overall, how would you describe your level of discontent with managed care companies?
23.Which aspect of managed care causes you the greatest overall frustration?
24.How likely are you to reduce your managed care patient load in the next 12 months?
25.SADA/DENTASA adequately represents private practitioners' interests in negotiations with managed care companies.
26.What action(s) should SADA and DENTASA prioritise in its engagement with managed care companies? (Select all that apply)
27.Are you willing to participate in further structured engagement (e.g. focus group, task team) on managed care issues?
28.If your response to Q27 is Yes, please supply your contact details in the comment box.
29.Any additional comments, concerns, or recommendations you would like SADA/DENTASA to consider: