Let's take a look at how the Filters work on your NHS Claims report
Reporting is made quick and easy in Dentally with the use of filters. Watch our video example below👇 or skip to our detailed breakdown here.
Video instructions...
Date allows you to search by Claim Submission date or Treatment Completion date.
From & Until allows you to choose a specific time frame that the claim was submitted or completed.
You can use the Practitioner filter to narrow down which dentists you are reporting on.
The Status allows you to view all claims under one specific claim status.
The Prior Approval Status works in the same way.
Lastly, the Contract filter means you can view all claims on a specific contract if you have more than one.
How to find claims that require my attention?
You should be using this report often to search for any NHS claims in a status that requires your attention. This way you can avoid out of dates claims and keep on top of you admin.
The descriptions below highlight exactly what each filter should be used for when running the claims report.
Underneath, you will find an example of what we are looking for and the settings you should be using to find all claims meeting the specification outlines.
Example 1 - I am looking for a list of all NHS claims without prior approval that requires my attention and potential action that have been submitted in the last week.
Date - set this to claim submission and it will only show those submitted in the date range we choose
From - set this as the start of the time frame you are looking for
Until - set this to the last day you are looking to report on.
Practitioner - Leave this as All if you are looking for all claims.
Status - Set this to one of three options to find those that require action. Error, Queried or Invalid.
We recommend running a report for each status to ensure nothing is missed.
Prior Approval Status - set this to not required, as we are looking at claims that do not require approval.
Contract - Set this to the contract you wish to report on if you have more than one at the practice.
Example 2 - I am looking for a list of all prior approval claims for provider X from the last month that have been approved.
Date - set this to claim submission, and it will only show those submitted in the date range we choose
From - set this as the start of the time frame you are looking for
Until - set this to the last day you are looking to report on.
Practitioner - Set this to Provider X
In this example, we have set it to look only for Dentists One's claims.
Status - Set this to all.
Prior Approval Status - set this to approved.
Contract - Set this to the contract you wish to report on if you have more than one at the practice.
Detailed Breakdown
When filtering on the following Status this is what you will see on the report...
Status: Submitted PA: Not Required
These claims have no PA on them and have been completed and sent to the board, we are now awaiting Received or Invalid returns from the NHS.
Status: Received PA: Not Required
These claims have no PA and have now been confirmed as received by the NHS.
Status: Invalid PA: Not Required
There is an outstanding response on the claim, this must be dealt with and the claim re-sent to the NHS.
Status: Error PA: Not Required or Required
The claim has not been sent as it has not passed Dentally validation for sending, check the claim for errors before resending (an example might be no valid treatment).
Status: Completed PA: Not Required or Approved
These claims have come back on a schedule to be paid and the fees balanced.
Status: Queried PA: Not Required
These claims have come back on a schedule but the amounts differ from what was requested, these should be reviewed and then moved to Completed manually if happy.
Status: Submitted PA: Required
These claims have a PA requirement and we are now awaiting for a Received response so we know the NHS has received the PA for processing.
Status: Received PA: Required
The PA claim has been received by the NHS and we are now awaiting approval.
Status: Invalid PA: Approved
These claims have now had a PA approved (there might be a response back with this PA to give a value for any “Fees as determined” codes). Now the work can be completed and the claim submitted against once done.
Status: Invalid PA: Denied
Your PA has not been approved by the NHS.
Status: Submitted PA: Approved
These claims have now had the full course of treatment completed and we have submitted the full claim and are awaiting a received response.
Status: Received PA: Approved
The final claim has been received by the NHS and we are now awaiting payment.