DTUK1610

June 14-20, 201024 DCPs United Kingdom Edition A s you know, we have just completed another contr- act year with the NHS. The race to complete all our allocated UDAs, or at least to fall within the four per cent of our contractual agreement to avoid clawback, alw- ays gets the adrenaline pumping. Due to previous bad experi- ences, we decided to be proactive and forward thinking. We moni- tor our UDA performance weekly, but what we usually fail to do is to check that associates are process- ing claims and payments correctly. This year, however, we ran an audit and discovered to that there were some errors. There was noth- ing too destructive, but it involved a loss of finance and as a result, we now check our schedules monthly. There isn’t much that can be done when it comes to certain claims. The loss of income simply has had to be written off as a bad debt, albeit it minimal, but a loss is a loss. But because of these situa- tions, we did some research into how claims were being made on the NHS and under what criteria depending on the patient. Some of the errors were down to poor com- munication between the dentist and patient, as well as the dentist and receptionist. Some errors were purely due to lack of knowledge and under- standing of the NHS contracts, which are full of red tape and don’t read easily. Emergency patients Booking emergency patients seems to be an area which causes the most confusion. It is also one of themaintypesofclaimsmonitored carefully by all PCTs. Unfortu- nately, the higher your emergency claims, the higher your practice is flagged on their data records. This leads to the PCT keeping a very close eye on you, which, to some of us, is an unfair disadvantage. However, we are all issued with contracts full of clauses, which are our duty and responsibility to read and understand. Once we had established what the actual causes of the errors we- re, with rightful claim, we did some thorough research, making use of our local PCT, as well as the BDA. We compiled all the infor- mation and handed a copy to each member of staff. We then held a training session to discuss each process when making a claim. To facilitate this, we are lucky eno- ugh to have an associate who is also a PCT adviser, who led an educational workshop. It was very informative and we all learned from the toolbox discussion. Complex claims The first complex claim is one in- volving taking note of whether a new patient should pay, or wheth- er they are entitled to discount or support if they fall into certain cat- egories, such as if they are on state benefits, are a student over 18 and in full-time study or an expectant mother – mothers are entitled to free NHS care up until the toddler is one year old. All patients eligible for support should be able to provide evidence tosupporttheirsituation.Ofcourse on many occasions, patients do not bring in their certificates de- spite being asked several times. If this happens, we have to indicate this on our administration system, and see the patient, as we are not allowed to turn patients away from receiving NHS treatment. Asking for support Whether you’re dealing with difficult patients or need specific information, contacting your PCT helps to build a good relationship. Sharon Holmes explains msc_ad_source_uk.pdf 1 03/08/2009 15:21:59