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This information is for England only. There is no schedule reconciliation as such for England and Wales as NHS Dental Services no longer pays for items of service, however, UDA/UOAs awarded on the electronic version can be reconciled with the paper schedule to ensure they match. NOTE: The NHS Dental Services have only sent UDAs/UOAs electronically since July 2007 so UDA/UOA adjustments can only be made on EXACT schedules from this date. |
Go to Administration > NHS > Payment Schedules
The date window that appears will automatically be set from three months ago to the current date. You can adjust this if needed.
Leaving the dentist field blank will load the schedules for all dentists within this period.
Double-click on a selected schedule to view the ‘Schedule Details’ screen. If there are any differences, these will be immediately visible if it is blank there are no differences. Differences occur when the EXACT and NHS Dental Services values for either UDAs or patient charge for a claim do not match.
Differences should be investigated thoroughly to see why the figures differ.
Your practice will be credited with the UDA amount written in NHS Dental Services column not the figure that EXACT has calculated. If you do not agree with NHS Dental Services figure, you can resubmit and resend the claim (this can be done by simply highlighting the claim and clicking the Resubmit button).
To investigate differences
Differences occur where NHS Dental Services have decided that the claim submitted was incorrect, but not incorrect enough to be rejected.They may have decided that the previous course for the patient impacted on this one or that there wasn’t a sufficient gap, or that a particular marker on the claim was incorrect. Differences can also arise where Observations have been included with the claim causing NHS Dental Services to assess the claim differently to the basic markers. Where the number of UDAs for a claim has been adjusted by NHS Dental Services the patient will usually have been adjusted too.
The first clue to a difference can usually be found in the schedule comments; these are shown on the lines underneath a schedule entry on both the screen and paper versions.Often NHS Dental Services have returned a UDA amount of zero, with a comment of “Claim Withdrawn”. The following comment will usually give the reason, such as “Overlapping Treatment”, “Active Ortho Course” or “Further Trmt Disallowed”. You need to decide whether you agree with NHS Dental Services’s Services’ decision in these cases. To help you decide EXACT EXACT gives you access to lots of information about the claim and the patient .
Clicking on the FP17 button gives you access to the FP17 that was sent with the claim. From here you can see the markers set for the claim, and any observations that were included.
To list schedules
Select Administration > NHS > Payment Schedules.
EXACT will ask you to select Date range and Dentists:
Enter the Date range and Dentist required (leave the Dentist box blank if you wish to see schedules for all Dentists within your selected date range).
Select OK to display the Payment Schedule List with a list of schedules, with dates and schedule numbers that will relate to the paper version.
In the Payment Schedule List, double-click on a schedule to show any differences between what you have claimed and what the Dental Board have paid you.
If it is blank, there are no differences.
If it has entries you can double-click on a schedule line to bring up a detailed view of the course of treatment, where you will be able to see:
The invoice history for the course.
When and if the course has been resubmitted before.
Which schedules the course has appeared on (double-click to see the comments on that schedule).
The treatment charted.
You will also have access to the patient’s Transactional history through the '£' button so you can see other courses that the patient has had and whether they overlap or infringe.
Having investigated why the difference has arisen, if you agree with NHS Dental Services' decision you can adjust EXACT’s UDA count (see below).
If you disagree with NHS DENTAL SERVICES’ decision then you can resubmit the claim - simply highlight the claim and click the resubmit button. Don’t forget to TC the claim again, and make any changes or add observations that will make NHS Dental Services reconsider.
once you double click on it.
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To adjust a difference
If you agree with the difference you can make an ‘adjustment’ to the schedule; this will change the totals held in EXACT (shown on the NHS Contract screen or the report.)
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Payment Schedule Details window example
To make an adjustment, click on the Adjust button. You will then see the Adjust Payment Schedule window appear and the adjustment to the UDA/UOAs will be in the UDA/UOA adjustment box.
Patient payment amounts can be adjusted here if required. If a patient amount is adjusted, remember that this may leave the patient owing money or in credit.
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Adjust Payment Schedule example
The ‘Comment’ field defaults to “Adjustment to Schedule [schedule number]”, but this can be edited if required.
Once all adjustments or resubmissions have been completed, you can click on the button to show all. This will take you inside the schedule to show all the claims. This can also be compared to the corresponding paper schedule. They should match identically. Any discrepancies should be noted and checked with NHS Dental Services.
Once you are satisfied that the schedule is correct you can close it and check all others in the same way. Be aware that you will need to relist the schedules to update the UDA/UOA totals after adjustments are made.
To report on UDA/UOA's
For a quick overview of your UDA/UOA values, you can simply refer to the ‘NHS Contracts’ screen. On this screen, you will see the following information:-
Contract Target
Achieved Value
Percentage achieved of target
Double-click on a contract to show additional information such as:
Breakdown by provider
Monthly Target
Courses of treatment associated with this contract.
In addition to this screen, there are some reports that can be used in regards to your NHS contract.
UDA/UOA Report
The UDA/UOA Report will show you the UDA/UOAs earned by providers. It can be broken down by date range and by contract. It can show additional information such as:
Resubmissions
Detail information about each claim
UDA/UOA Breakdown Report
The UDA/UOA Breakdown report will show you UDA/UOA earned by providers. It is broken down by:
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Band
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Contract
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Click on the claim in the list
Click on Adjust at the bottom of the window
