The following instructions relate to submitting an ortho claim in England & Wales.  For submission in Scotland you will need to read the NHS Scotland Ortho Submission webpage

An Ortho claim is submitted in 2 stages.

Once you have completed  your Ortho case assessment, return to your treatment plan. Click on Submit.  (If you need help with completing your orthodontic case assessment, take a look at our web page.)

Dentally knows the Treatment Plan contains Ortho treatments, and so only allows you to Submit an NHS Ortho claim. You now select whether to submit the First or Second Claim.

Submit the First claim when you have assessed patient and fitted an appliance OR have assessed the patient and are not undertaking any further treatment at this point

Submit the Second claim when you wish to inform NHSBSA that the orthodontic course of treatment is completed.

Submit First Claim

Check the Exemption and contact fields are correctly filled in. Check that the treatment you are claiming for is correct. Notice that the Treatment Plan that the claim refers to is shown in the screen so that you can quickly refer to it if you need to during the submission process. Click on Next to continue.

Check that the assessment details are correct, including the IOTN Score - which is a mandatory field.

If the patient is not ready for one reason or another, you send that as "assess and advise" or "assess and refuse" and you will be awarded 1 UOA.

If you carry on and fit an appliance, and mark the claim "Assess and Appliance Fitted", and you send it off as part of the First Claim once the appliance is fitted, you should be awarded 21 or 23 UOAs. Click on Next when ready.

Check all declarations. If all are true, you can use the "Check all declarations" button.

When you are ready, click on Submit. The claims wait in a queue for up to 1 hour before they are submitted to the NHS servers. This allows you to edit and change the submission. After the hour, the status changes from Queued to Submitted. You can check the status of claims from the NHS Claims Report.

Submit Second Claim

When the course of treatment is finished and the appliance is removed, you use the SAME treatment plan to send the second part of the claim which closes it. You are not awarded any further UOAs.

From the SAME treatment plan, click on Submit Second Claim.

Check the first treatment screen is correct. Click on Next.

There are 3 completion choices - Treatment abandoned, Treatment discontinued, and Treatment Completed.

The IOTN Score is a mandatory field.

If Treatment is Completed, a further Aesthetic component also becomes mandatory.

If Treatment is Abandoned, the Reason field defaults to Patient failed to Return, but there is another option, of Patient Requested.

Once all the mandatory fields are complete, add any further information and click Next when ready.

Check all declarations. If all are true, you can use the "Check all declarations" button.

When you are ready, click on Submit. The claims wait in a queue for up to 1 hour before they are submitted to the NHS servers. This allows you to edit and change the submission. After the hour, the status changes from Queued to Submitted. You can check the status of claims from the NHS Claims Report.

NHS Claims Report

You can filter your NHS Claims Report by Ortho submissions, as well as by claim Status, Practitioner and date range.

Ortho claims are easily distinguishable from non-ortho claims as they tell you the number of UOAs awarded, the reason for treatment and the claim status.

Related Web pages

This web page tells you about the process to submit and report on Ortho claims in England and Wales.
If you need help with completing your orthodontic case assessment, take a look at our web page.
We have a suite of web pages for the Ortho process in NHS Scotland.
Submit a Prior Approval in NHS Scotland
Submit an Ortho Exam claim in NHS Scotland
The NHS Scotland Ortho Submissions Report.
If you need any more help, please contact the Dentally Support Team.

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