Dealing with NHS claims and queries
How to deal with an NHS claims returned as a query - UDAs not as expected or claim more than 2 months late
Shelley Withington avatar
Written by Shelley Withington
Updated over a week ago

Occasionally you may have NHS claims returned with an error message or query. Any claims that have been returned show in your notifications.

NHS Query Reasons

There are 2 main reasons why NHS claims are queried:

  1. NHS claims are late

  2. Practitioner has not received the UDAs expected

Use the NHS Claims Report, which will show practitioners their own NHS claims, and those with permissions levels 3 and 4, NHS claims for all practitioners in the practice.

NHS Claims Report

  • Starting from the NHS Claims Report, set your filters to the dates you are looking at, and the status as Queried.

Dentally NHS Claims Report - Filter by Queried status

Any Claims with issues will show the response message from NHSBSA in the Comments section. This can also be seen in the patient's record, in NHS > Claims.

Late Submitted Claims

Claims sent more than 2 months after their completion date are out of date and will not, generally, be paid.

The completion date of a claim is set when submitting a claim and is set to the date you go to submit the claim, but this can be overridden when submitting.

Fixing the issue:

If the completion date of the claim was incorrect and needs to be amended, then simply open the treatment plan which was used to raise the claim and go through the submission procedure again, correcting the completion date when sending.

If the claim is genuinely out of date, then the claim should be marked as Complete, in order to settle it and remove it from your UDA Queried total. This will set the claim status as Complete, but will not record as awarded UDAs in your NHS UDA report.

  • Open the patient's record

  • Go to the NHS Claims tab

  • Use the drop down option by the claim's state to change it to Complete

This claim will now show in the Completed Status on the NHS Claims Report but will not show any UDAs awarded against the treatment.

UDA Value not as requested

Some queried claims have been returned by NHSBSA because they have not been awarded the UDA value requested.

It is up to each practitioner or practice to contact the NHSBSA and find out what the issue is for the claim. Once the issue has been resolved, you can alter what is required and submit the claim once again.

Or you can decide that you accept the UDAs you have been awarded. In this case:

  • Open the patient's record

  • Go to the NHS Claims Tab

  • Use the drop down option by the claim's state to change it to Complete

This claim will now show in the Completed Status on the NHS Claims Report and will show the UDAs awarded against the treatment in the NHS UDAs Forecast report.

NHS Claims Report

Remember to check back on your NHS Claims Report, or your notifications, to make sure that you do not run out of time with these NHS claim submissions.

NHS UDAs Forecast Report

You can always keep track of NHS claims using the NHS UDAs Forecast Report which will warn you when claims are in danger of falling outside the 2 month claim window.

Exception to the Rule - Incomplete Claims

You can claim for incomplete treatment even if the last visit date was more than 2 months before the date of the claim. You should try and claim for incomplete treatment within a 2 month period, but if a patient fails to return, you will be able to claim for incomplete treatment outside of the 2 month end date.

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