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Table of Contents
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Capitation Reports

Capitation Scheme Profile Report

The Capitation Scheme Profile Report provides a breakdown of the capitation scheme by age, sex and band.

Selection of data for the report can be made by date, one or more providers, and payor:

...

The report shows the changes that occurred during the reporting period, e.g., New Members, Number that Left, Net Change, Estimated Collections, and some Appointment information. All information is given per provider.

  • The estimated monthly collection figures are based on the number of members at the end of the selected period, multiplied by the current monthly fee entered for each band.

  • The estimated collections for period, takes the monthly collections rate and multiplies it by the number of days in the period.

  • The hourly rate is based on the total length of completed appointments within the period. It does not take account of double bookings or reserved time which was not utilised. Where patients have no band assigned, a monthly fee of zero is used, which will distort the overall collections, and hourly rate figures. Where a particular band has had no completed appointments within the period of the report an hourly fee cannot be calculated and will be shown as zero.


Capitation vs Private Report

This is a ‘what if’ report that attempts to be a “crystal ball”, advising on what fees the practice might have earned if the work they carried out under a capitation payor had in fact been done privately. This report gives the practice some guidance on whether they would be better off converting their patients to private or staying with the Capitation Scheme. It can also show them whether a particular band is over/under-priced against their standard fees.

The report works by looking at the work done under the capitation scheme and determines what the private fee for the same item would be. Therefore the services carried out under the capitation scheme would require a price set against them in the service list in order to generate a private fee equivalent.

It is designed to give an indication, but cannot be considered wholly accurate as there are too many variables which could influence what the private item might have been charged at. The report only uses the standard price for the comparison.

...

The estimated monthly collections is based on the number of members at the end of the selected period, multiplied by the current monthly fee entered for each band. The estimated collections for period takes the monthly collections rate and multiplies it by the number of days in the period. Where patients have no band assigned, a monthly fee of zero is used.

Provider Breakdown is based on patient’s owning dentist. Note a single provider may not have done all of the work shown against their name.


COT Costs Exceed Invoices Report

This report identifies Payment Plans where the costs incurred so far are greater than the instalments that have been invoiced to date.
You can review these plans to determine if the value or frequency of instalments should be altered to ensure that costs are covered throughout treatment.

The report can be by provider, or for multiple providers, or for a single Provider category.
You can choose whether full COT details are included, or the report is in summary format only.

To run the COT Costs Exceed Invoices report

  1. From the Reports menu (Administration > Reports) select "COT Costs Exceed Invoices":

    Print COT Costs Exceed Invoices windowImage Modified
  2. Enter a provider code in the "Provider(s)" field, or click in the field and use the

    Image Modified

    or

    Image Modified

    button to select one.
    For multiple providers, click the

    Image Modified

    button and select the providers you want to include.
    For providers belonging to a particular Provider Category, enter a Category code in the "Provider Category" field, or click in the field and use the

    Image Modified

    or

    Image Modified

    button to select one.

  3. Click in the "Include full COT details" checkbox if you require the details on the report.

  4. Click the

    Preview buttonImage Modified

    button if you want to check the report details before you print it, otherwise click the

    Image Modified

    button.


Denplan Reports

Assessments Done Reports

This report counts all assessments done in the date range you specify, and reports these in tabular form.


To run the report:

  1. Select Administration > Reports and under the Reports tab double-click the Denplan Assessments Done Report.

  2. Specify the From - To date range:

    • Enter the date range, or

    • Choose dates using the drop-down menu on each field, or

    • Click the

      Calendar buttonImage Modified

      button to select a date from the calendar.

  3. Select Print, Preview or Email.

    Denplan Assessments Done Report dialogImage Modified


Example Report:

...

Note that theAge columns are based on the age of the patients at the time the assessment was performed.


Assessments Due Report

This report lists all Denplan patients due or overdue for an assessment.


The Denplan Assessments Due dialog asks for a date by which all Denplan patients should have had an assessment redone.
The report runs through all Denplan patients, reports any patients who are overdue for an assessment, and notes when their most recent Assessment was done.


To run the Denplan Assessment Due Report

  1. Select Administration > Reports and under the Reports tab double-click the Denplan Assessments Due Report.

  2. (Optional) Select the Show Detail option to add these columns to the report, with the current band highlighted for a patient if it differs from the last assessed band:

    • Name

    • Last Assessed

    • Last Assessment

    • Current Band

  3. Select Print, Preview or Email.

    Denplan Assessment Due Report dialogImage Modified


Sample report output (detailed version shown):

...

NOTES:

- An Export option is provided. This will give access to the patient's address, so you can use the report to produce a mail merge if you wish.

- The Last Assessment column shows both the assessed band and the score that generated it.

- The Current Band column shows the current band from the patient file, and is highlighted if it differs from the last assessed band.

- Run both the Capitation Scheme Profile Report, and the Capitation vs Private Report, for an overview of how your Denplan scheme is running.


Integration Report

The Denplan Integration Report calculates the potential financial gain in converting current patients to Denplan.

  1. Select Administration > Reports and under the Reports tab double-click the Denplan Integration Report to load the report window:

    DenplanIntegrationReportImage Modified

    (Note the options to Print, Preview, Email or Export to .CSV)

  2. Sort patients by

    By default, the report will display patients sorted in order of Last Name. To sort the report by another criteria, click the dropdown button and select another sort method from the menu:
    DenplanIntegrationReport-SortImage Modified

  3. Specify whether to include or exclude inactive patients by checking or un-checking the Include Inactive checkbox.

  4. Select Patients

    Use the Select Patients field to select, edit or create a new query to define the patients, making it possible to print Statements for selected groups of patients as defined in the query:

    SelectPatients-QueryImage Modified

    See also these resources for related Queries information:

    video-icon_12x12pxImage Modified Video series for Contact Lists and Queries Open in New Window iconImage Modified (multiple videos)

    video-icon_12x12pxImage Modified Mini-masterclass - Contact Lists icon_OpenInNewWindow_10x10_bluImage Modified

  5. Specify further report criteria as follows:

Provider(s)

To limit the report to just the patients of one or more providers, select the provider using the Image Modified or Image Modified buttons, or the Image Modified button to select more than one provider.

Provider Category

To limit the report to just those providers belonging to a particular Category, select the category using the Image Modified or Image Modified buttons.

Payor(s)

To limit the report to just the patients with a particular payor, select the payor using the Image Modified or Image Modified buttons, or the Image Modified button to select more than one payor.

Sort by...

Provider or Payor

These (mutually exclusive) option buttons allow you to sort the report according to provider name or by payor. The information in the report is calculated in the same way, but the layout is slightly different.

Show Detail checkbox


If checked, the detail regarding the patients under each section will display. This will include the patient’s name, provider and whether they are a child, exempt patient or an adult. If the checkbox is unticked, only the header information for each Payor will be displayed as well as the summary.
The Summary section will display the Total Summary by Payor, as well as the percentage of selected patients per band.


Edit Layout buttonImage Modified

Edit Layout: Click this button if you need to make changes to the report layout.

Image Modified

Send the report to the printer.

Preview buttonImage Modified

Preview the report before or instead of printing it.

EmailImage Modified

Email a copy of the report to an email recipient.

Image Modified

Export: Export the report details to a file that can be then used by a spreadsheet or word-processing program.

Image Modified

Close the window without printing the report.


NOTES:

The figures used to calculate patient Denplan scores are based on historical treatment alone; this does not include gingival condition, periodontal status or plaque control. As a result, these figures do contain a certain amount of inaccuracy and should therefore be used only as a guideline.

The band information displayed on this report is based on the Denplan banding system but Denplan should be contacted directly if a full risk assessment is required.

If when you run the report,

...

EXACT finds services which do not have a Denplan category set, it will display the Denplan Setup window to enable you to assign them.

Report Example:

...

This shows an upper part of the report body, with details turned off.

The information in the summary pages of the report appears as in these examples:

...


Earnings Summary Report (NHS)

This report is designed to show how payments received by the practice are divided into NHS, Private, Stock item and Deposit payments.

  1. Select Administration > Reports.

  2. In the Reports desktop, double-click the Earnings Summary report to open the Print Earnings Summary window:

    Print Earnings Summary windowImage Modified
  3. Specify a Query Template in the Select Patients field, either by scrolling up/down or by means of the View Query Templates window:

    8387-SelectQuerytemplateImage Modified

    (from here you can also edit Query Templates or create new ones by means of the +1 button).

  4. Specify Provider/s as follows:

    • To print an Earnings Summary report for the entire practice, leave the Provider(s) field empty

    • Select an individual provider by means of the scroll buttons

      Image Modified

      .

    • Specify a combination of Providers by means of the Multiple button

      Image Modified

      .

  5. Define the date range for the report by means of the From and To date fields.

  6. Show Details?

    • Tick (select) this checkbox to provide details for the receipts and invoices that make up the report.

    • Leave this checkbox unchecked to show only a summary of the payments and the payment methods, dividing them into types of payments.

  7. Click Print to send the report to the printer, Preview to preview on screen and then print from the Preview screen, Email to email a copy of the report to an email recipient, Export to create a file readable in Excel, or Cancel to return to the previous screen.

    The example below shows an Earnings Summary report for the entire practice and all Providers, in summary format (with Show Detail not selected):

    Earnings Summary print previewImage Modified


Interpreting the Earnings Summary Report

With Show Detail checked (ticked):

The report is divided into columns:

Patient Receipts

This column lists; the date of the receipt/payment and the patient’s name. The next column shows the receipt number along with the payment method used.

Total

This column shows the total value of the receipt.

NHS Payor

This column displays the payor (NHS) portion.

NHS Patient

This column shows the patient’s portion of the receipt that was for NHS treatment.

Private

This column shows the portion of the receipt that was for private treatment.

Stock Items

This column shows the portion of the receipt that was for stock items.

Deposit

The portion of the total that was unallocated, and therefore is considered as an advance payment.

Summary Section

This area summarises all of the receipts into: Cash, Cheque, Visa etc, and also into NHS invoices and adjustments. Each payment method is then divided further into categories showing NHS payments, private payments, stock item payments and deposits.


With Show Detail unchecked:

Only a summary section is printed:

...


Friends and Family Survey Report (NHS)

This report covers the results of NHS-compliant, Clinipad-based Friends and Family Testing.

The report parameters include

  • A choice of Provider/s (if multiple, a choice of whether to combine them in a report or report each separately)

  • Patient demographics (gender, age and ethnicity)

  • Whether to include the respondents' text comments in the report.

    NOTE: Anonymity is built into Friends and Family Test functionality in multiple ways to guard against practitioners linking respondents with particular answers


Note that report data needs to be uploaded to the NHS Portal.


To run the Friends and Family Test report

  1. Select Administration > Reports and select the NHS Friends and Family Test Report:

    RunFFT-1Image Modified
  2. From the parameters dialogue select parameters as follows:

    RunFFT-2Image Modified

    Overview: From this screen you can choose parameters for Provider/s (if multiple, whether to combine them in a report or report each separately), patient demographics (gender, age and ethnicity), and whether to include the respondents' text comments in the report.

    Report parameters:


    Provider/s

    Reports by Provider may be of significant interest to patients.

    Use the selectors to select a Provider, or click the Multiple button to select multiple Providers:

    RunFFT-3Image Modified

    (With multiple Providers you have the option of reporting them together or separately)

    Date range to cover

    The default range is the previous complete month. Minimum range is 1 month to prevent anonymity being breached.

    Breakdown by

    (demographic filter)

    If you choose a demographic breakdown the grand total will be broken down by either

    Male/Female

    Age (at time of test) 0-17, 18-29, 30-39, 40-49, 50-59, 60+

    Ethnicity (one row for each)

    Option to include text comments

    If text comments are included, they will be printed in a list under the numbers on the report.

    To preserve anonymity they cannot be identified by date or demographic data.

    A tick is shown next to each entry where the patient has selected NOT to allow their comment to be made public.


  3. Print, Preview or Email the report. If Emailed you can preview it from the

...

  1. EXACT Email Outbox.


Income Cycle Reconciliation Report

This report is designed to show an overall financial position of income due to the practice.

The following information can be obtained from this report:

  • Total amount of invoiced work due to be paid to the practice in a previous period.

  • Value of new work that has been invoiced since the previous period

  • Adjustments made to previous invoiced work

  • Receipts from patients since the previous period

  • Adjustments made to previous receipts.

  • NHS Dental Services figures for monies due to be paid by NHS Dental Services to the practice

  • Another feature of the report is the ability to select & print individual reports giving further breakdown for the figures shown in the main report.

To Run the Income Cycle Reconciliation report

  1. Select Administration > Reports > Income Cycle Reconciliation:

    Image Modified
  2. Leaving the Provider(s) field empty will print an Income Cycle Reconciliation report for the entire practice; however an individual provider can be selected from the list by using the

    Image Modified

    button.

  3. Clicking the

    Image Modified

    button will allow printing for a combination of Providers.

  4. Alternatively, you can leave the Provider(s) field blank and select all providers belonging to a provider Category by selecting a Category in the Provider Category field.

  5. The From and To date fields will default to the beginning and end dates of the previous full month, but can be changed to define a different date range for the report.

  6. Click Print to send the report to the printer, Preview to preview on screen and then print from the Preview screen, or Email to email a copy of the report to an email recipient, Export to produce a copy suitable for importing into a spreadsheet or word-processor, or Cancel to return to the previous screen.

  7. If Preview is selected, the following window will provide additional display and print options:

    Image Modified
  8. Click Print All to send all sections of the report to the printer, or Print for the options checked. Click Export All to create a file of all sections of the report readable in Excel, or Export for the options checked. Otherwise click Close to return to the previous screen.

Interpreting the Income Cycle Reconciliation Report

Main Report

The main report is divided into several sections by header:

Opening Balances Section

Displays the total balance figures for both patients and DPD, prior to the ‘From’ and ‘To’ dates for the report. As schedules are reconciled, NHS Dental Services figures will change.

Written off invoices from previous period

Lists any written off invoices that have been carried forward.

Value of new invoiceable work

Displays amounts for items invoiced within the report dates, broken out by Private, and Patient and DPD portions of NHS treatment.

Adjustments to invoiced work from previous period

Displays any adjustments that have been made to invoices prior to the report date range.

Money received from Patients

Displays receipts from patients that have been allocated to invoices created within the report date range and for the previous period, as well as money received for work not yet invoiced.

Adjustments to receipts

Displays any adjustment amounts that have been made to patients receipts prior to the report date range.

Closing Patient Balance

Displays the total amount owed by patients to the practice as at the date entered in the ‘To Date’ field for the report. This is an overall financial position of monies owed to the practice by patients.

Closing NHS Dental Services Balance

Displays the total amount that is owed the practice, but not yet been paid, by the DBP as at the ‘To Date’ field for the report. As schedules are reconciled this amount will change.

Additional Reports

A number of additional reports are also available to be printed by ticking the box next to the required report. The figures shown rely upon the dates entered for the main report.

If all of the breakdown reports are required, then the user should select the ‘Print All’ button instead of ticking all the boxes.

NOTE:Some of these reports are also available to be printed from within their own report menus. A brief description of these reports, and where else they can be found is as follows.


Debtors List

(Opening Patient balance report Option)

Shows patients who owe money prior to the report dates, splitting the total balance into 4 columns showing the overdue balance according to the number of days it remains unpaid.

This report can also be printed directly from the ‘Reports’ list.

Opening NHS Dental Services Balance Report

(Opening DPD balance report Option)


Shows amounts not yet paid by the DPD prior to the report dates.

This report can also be printed from the ‘Administration’ menu, under ‘NHS’, ‘List Courses of Treatment’, by pressing the Image Modified button.

Write-offs From Previous Period

(Written off invoices report option)


Shows amounts written off, and a total of all write offs prior to the reporting dates.

This report can also be printed from the ‘Transactions’ menu, under ‘List Items’, ‘List Write-offs’, by pressing the Image Modified button.

New Invoiceable Work (New Invoiceable work report option)

Shows amounts invoiced to Patients for the report date range, split into columns for Private, NHS & NHS Dental Services, with a grand total for each column.

Adjustments To Invoiced Work for Previous Period (Adjustments to invoiced work option)

Shows adjustment amounts made to invoices prior to the report date range, split into columns for Private, NHS & NHS Dental Services, with a grand total for each column.

Money Received from Patients (Money received from Patients report option)

Shows dated receipts from Patients within the report date range, split into columns showing the Provider, Payment Method and Amount, together with grand totals for each payment method and an overall total.

Adjustments to Receipts from Previous Period (Adjustments to receipts report option)

Shows adjustment amounts made to receipts prior to the report date range, split into columns to show the Provider, Payment Method and Amount, together with grand totals for each payment method and an overall total.

Money Paid By DPD (Money from DPD report option)

This report shows money that has been received from the DPD. This report needs to be run after reconciling and processing a NHS schedule through

EXACT

EXACT.



Lapse List

This report is used to print a list of patients whose NHS registration is due to lapse during a specified time period.

The resulting report includes the following:

  • Patient Name

  • Patient Phone Numbers

  • Patient Balance

  • Patient’s dentist

  • Lapse Date

  • Acceptance Date

  • Last Exam Date.

To Run the 'Lapse List' Report

  1. From the ‘Administration’ menu, click ‘Reports’ and select ‘Lapse List’:

    Image Modified
  2. By using the 'Select Patients' field, a query can be selected or created, making it possible to print this report for selected groups of patients as defined in the query.

  3. The Provider field will default to the user logged in. Blanking out the field out will print a ‘Lapse List’ for the entire practice. A different provider can be selected from a list by using the

    Image Modified

    button. Having a provider selected will print the list of only that provider’s lapsed patients.

  4. The 'From' and 'To' Date fields are used to define the future date range for which to print the report.

  5. The ‘Types’ fields allow two different criteria to be selected to narrow down the list. If required, use the

    Image Modified

    button to select an option in either field.

  6. Click ‘Print’ to send the report to the printer, ‘Preview’ to preview on screen and then print from the ‘Preview’ screen, or ‘Cancel’ to return to the previous screen.

    The example below shows a ‘Lapse’ List for the patients of provider DEMO, whose NHS registration is due to lapse during a future time period.

    Image Modified


NHS Claimed Versus Paid Report

Use this report to compare the UDAs claimed versus claims paid by the NHS.

The report provides more detailed comparisons than the NHS Schedules Reconciliation.

It runs additional checks in the database table(s) to find hidden / actual differences between what was claimed and what was received/paid.

It reads all schedules with a date on or after the specified reporting date. For all schedule items in that schedule

...

EXACT finds the most recent claim record for the associated COT and uses that to obtain the report data.

To run the NHS Claimed Versus Paid Report

  1. Open the print dialogue by any of these means:

    • Select Administration > Reports and then in the Reports screen select NHS Claimed Versus Paid Report:

    Reports-NHSClaimedVsPaid-open1Image Modified


    • Select Administration > NHS > NHS Claimed Versus Paid Report:

    Reports-NHSClaimedVsPaid-open2Image Modified


    • From the configured NHS shortcut in the workspace bar select Claimed Versus Paid Report:

    Reports-NHSClaimedVsPaid-open3Image Modified


    The Print NHS Claimed Versus Paid Report dialogue opens:

    Reports-NHSClaimedVsPaid-dialogImage Modified


    Performer/s

    Select or filter Provider/s.

    Date From

    The date from which schedules should be considered.

    EXACT will read all schedules with a date on or after the specified reporting date.

    For all schedule items in that schedule EXACT finds the most recent claim record for the associated COT and uses that to obtain the report data.

    Show only differences

    Check (tick) this box to indicate only claims with claimed/paid difference.



  2. Select Print, Preview, Email or Export to generate the report.

    Example:

    Reports-NHSClaimedVsPaid-output1Image Modified

    Detail example:

    Reports-NHSClaimedVsPaid-output2Image Modified

    Export example:

    Reports-NHSClaimedVsPaid-output3Image Modified


Generating NHS Contract Exceptions Report

This topic covers the reason for this report, its features, and how to run it.
SEE ALSO: NHS Contract Exceptions Report Explanation for detailed information on its various fields.

Background

NHS practices receive a quarterly report from their PCT, outlining how they did for the previous 5 quarters against 22 Key Performance Indicators.

Because they are judged on these KPIs and their performance influences whether they can get additional UDA contracts or payment for their existing contracts, NHS practices need a way to see how they are tracking against the KPIs ahead of time so that they can correct if necessary.

Report features

The report does the following:

  • Produces the same historical data (or very close) as the official report for the statistics that it offers.

  • Runs for the current period, so that a site can course correct if necessary.

  • Runs per provider, so the site can zoom in on problems.

  • Is able to run for the current quarter as well as the previous 5 quarters. The quarter boundaries are:

    • 1st January - 31st March

    • 1st April - 30th June

    • 1st July - 30th September

    • 1st October - 31st December

  • Runs for the current quarter even if it is not complete. It does not run for future quarters.

  • It can be scheduled and exported.

...

  • EXACT stores the default threshold values as settings, so that they can be updated by the user as required if they change.

  • Values that exceed the threshold are marked with the Warning "Over".

  • Values within 10% of meeting the threshold are marked with the Warning "Near".

To run the NHS Contract Exceptions Report

  1. Select Administration > Reports

    Administration-ReportsImage Modified
  2. Double-click the NHS Contract Exception Report to display the Print NHS Contract Exception Report window:

    29560,v11.4Image Modified
  3. From this window, select the required parameters for the Report.
    Note that you can optionally select Multiple Providers.

  4. Optionally Preview.

  5. Print normally.

Example of a report, showing all of the same performance indicators as the one that you received from your local area team:

...


NHS Contract Exceptions Report explanation

Continued from Generating NHS Contract Exceptions Report...

...

Exception Indicators of Fragmentation (Splitting) of courses of treatment:


Exception Indicator:

FP17s within 3 months of a previous course of treatment

Rationale

Relatively high rates of forms per patient within a quarter could be caused by high levels of continuations of treatment or free repairs and replacement. High rates of these may be a reflection of failure in the quality of treatments being provided. A common cause is the separate submission of assessment and treatment claims – which is not generally allowed under national regulations. Very high frequency recalling of patients would also have an upward pressure on this rate as would high levels of unplanned treatments, such as urgent or trauma treatments.

Numerator

The number of FP17s (adult, child, total) scheduled during the quarter where there was a previously recorded course of treatment ending less than three months previously.

Where there is no recorded end date (incomplete treatments), the date of acceptance is used.

Denominator

The number of FP17s (adult, child, total) scheduled during the quarter.

Threshold

The outlier threshold for this indicator is based on the distribution of rates across contracts for the whole of England and Wales and is calculated as one and a half times the inter-quartile range above the upper quartile.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

Indicators such as Free Repair and Replacement; Continuations; Late Reporting; Band 2 and 3 starting and ending on the same day; FP17s within 12 months; FP17s within 3 to 9 months; as well as other investigations will help to understand the underlying causes.

Exception Indicator:

Band 2 or 3 starts and ends on the same day

Rationale

If the course appears to start and end on the same day, this could indicate that a contractor is submitting separate claims for the assessment and treatment visits. The remuneration for assessment is included in the allocation of UDA for band 2 and 3 treatments so the dentist will be over-compensated for the treatments provided.

Where the contract is flagged as an exception, further investigation should take place to establish if courses of treatment are being split or if dates are being improperly recorded on the returns.

Numerator

Number of Band 2 or 3 FP17s scheduled during the quarter where the date of completion is the same as the date of acceptance

Denominator

Number of Band 2 or 3 FP17s scheduled during the quarter

Threshold

The outlier threshold for this indicator is based on the distribution of rates across contracts for the whole of England and Wales for 2010

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

This indicator may be part of the explanation for a high number of forms per patient and high numbers of recalls within 3 to 9 months, as well as a high band 2 or 3 rate per patient within 12 months.

Exception Indicator:

Band 2 or 3 rate per 12 months

Rationale

Where a provider appears to have a high proportion of treatments within 12 months of a previous treatment it is possible that there is a failure to provide adequate preventative advice or treatment during the earlier course of treatment.

Alternatively it is possible that intended dental courses of treatment are being split across two claims, rather than being provided in a single course. Measuring Band 2 or 3 rates within 12 months of a previous band 2 or 3, in adults will give a slightly more subtle measure of splitting issues than shorter period recalls. For example dentists splitting treatments over 4 months or recalling for the next phase of treatment, will have higher rates here.

Numerator

Adult band 2 or 3 treatments (FP17s) in the last 12 months.

Denominator

Adult band 2 or 3 treatments (FP17s) in total.

Threshold

he outlier threshold for this indicator is based on the distribution of rates across contracts for the whole of England and Wales in 2010

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

FP17s within 12 months of a previous (below) includes checkups as well – and will detect splitting of checkups from treatments. This indicator can be used in conjunction with FP17s within 3 months of a previous and FP17s within 3 to 9 months of a previous FP17.

Exception Indicator:

FP17s within 12 months of previous

Rationale

This indicator could result from a practice policy to maximise UDA within the contract. Exceptionally high rates are likely to be associated with practices with a recall policy not in line with NICE guidelines, for example a default maximum recall period of 12 months for adults.

Numerator

Number of FP17s scheduled during the quarter where there is a matching previous FP17 where the completion date on the earlier FP17 is within 12 months of the acceptance date of the later one.

Denominator

Number of FP17s scheduled during the quarter.

Threshold

The outlier threshold for this indicator is based on the distribution of rates across contracts for the whole of England and Wales in 2010

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

This indicator may be associated with Free Repairs and Replacements Continuations; Forms per patient etc

Exception Indicator:

Free repair and replacement rates

Rationale

Where there are high numbers of free repairs and replacements this will compromise the levels of access in the practice. In addition it could be an indicator of a failure to provide an adequate level of quality in treatments, and an unnecessary diversion of resources.

Numerator

Number of FP17s scheduled during the quarter where there is a free repair or replacement indicated.

Denominator

Number of Band 2 or 3 FP17s scheduled during the quarter.

Threshold

The outlier threshold for this indicator is based on the distribution of rates across contracts for the whole of England and Wales and is calculated as one and a half times the inter-quartile range above the upper quartile.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

Free repairs and replacements could be an underlying cause for exceptions in other indicators including UDA per patient and Forms per patient.

Exception Indicator:

Continuations of treatment

Rationale

There is a much higher than expected number of claims for continuation of treatment, in many cases for patients whose initial course of treatment was only Band 1 (i.e. examination, scale and polish etc). This could indicate a misunderstanding by the provider, of the requirement to identify all the required treatment at the outset and to submit a single claim for all necessary interventions.

Numerator

Number of Band 2 or 3 FP17s scheduled during the quarter where there is a continuation of treatment indicated.

Denominator

Number of Band 2 or 3 FP17s scheduled during the quarter.

Threshold

The outlier threshold for this indicator is recalculated each quarter and is based on the distribution of rates across contracts for the whole of England and Wales. It is calculated as one and a half times the inter-quartile range above the upper quartile.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

High Continuations rates may explain other indicators such as Forms per Patient and UDA per Patient.


Exception Indicators of adult patient mix and re-attendances:

Exception Indicator:

Adult FP17s within 3 to 9 months of a previous FP17

Rationale

Where there are exceptional rates of multiple claims per adult between 3 and 9 months the commissioner may want to understand the providers recall policy, to ensure it is not being used to maximise UDA and that it is consistent with agreed standards for oral health maintenance. A default recall policy with a relatively short interval, for example, would not be seen as an appropriate use of resources

Numerator

Number of FP17s for adults between 3 and 9 months of a previous claim

Denominator

Number of FP17s for adults

Threshold

The outlier threshold for this indicator is recalculated each quarter and is based on the distribution of rates across contracts for the whole of England and Wales in 2010.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

Adult FP17s within 3 and 9 months may be associated with high UDA per patient and high rates of band 2 and 3 claims within 12 months.

Exception Indicator:

Adult exemption mix (high, low)

Rationale

The mix of exempt and non-exempt adults at a contract will vary quite widely across contracts for a number of reasons, not least the underlying socio-economic mix of the catchment population of the dental practice. However, an exceptional rate for this indicator could also be a sign of access problems, for example where a practice is not giving equal access to exempt and non-exempt patients, or where non-exempt patients are being diverted into private treatments. Commissioners may want to ensure that the access policies at the practice are not discriminatory and that the full range of treatments expected within the NHS are available to everyone who requires them.

Numerator

UDA from non exempt adults scheduled during the quarter.

Denominator

UDA scheduled from all adults during the quarter.

Threshold

There are two indicators and two exception thresholds. For high proportions of non-exempt patients the threshold is based on the national distribution in 2010 and has been set at two IQR above Q3. The low rate is set at 2 IQR below Q1 based on the same distribution.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

N/A


Exception Indicators of Patient Case-Mix:

Exception Indicator:

UDA per Form

Rationale

A high UDA rate per form is a fundamental indicator of the profile of bands of treatment at the provider. Exceptional rates need to be investigated to ensure that the range of treatments being provided covers the full range of services expected of NHS contracts, and is not intended to maximise the UDA rate. For example, the proportion of inlays among tooth restorations can have a dramatic effect on the UDA rate per form in some contracts

Numerator

UDA scheduled during quarter

Denominator

FP17s scheduled during quarter

Threshold

The outlier threshold for this indicator is recalculated each quarter and is based on the distribution of rates across contracts for the whole of England and Wales. It is calculated as one and a half times the inter-quartile range above the upper quartile

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

High levels of Band 3 to Band 2 treatments might influence this indicator, more specific indicators such as high inlay rates compared with fillings will be of interest to commissioners.

Exception Indicator:

No clinical data

Rationale

All treatment FP17s would be expected to provide information about the treatment in the form of clinical data. The treatments are chosen from about 20 categories which includes an option for ‘other treatment’. Band 2 and 3 FP17s should not be submitted without any clinical data.

Numerator

Number of FP17s with no clinical data set.

Denominator

Total FP17s scheduled during the quarter.

Threshold

The outlier threshold for this indicator is recalculated each quarter and is based on the distribution of rates across contracts for the whole of England and Wales. It is calculated as one and a half times the inter-quartile range above the upper quartile.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

N/A

Exception Indicator:

Band 3 to 2 rate

Rationale

Attention tends to focus on fragmentation of treatments as a cause of excess UDA per patient. A completely different reason for high UDA rates is the mix of band 3 to band 2 treatments. Band 3 treatments carry four times the UDA of a band 2. Commissioners will want to understand the justification for exceptionally high ratios of band 3 to band 2 treatments. An example which has been found to be a significant factor in some contracts is high rates of inlays compared with fillings

Numerator

Band 3 adult FP17s scheduled in the quarter.

Denominator

Band 2 adult FP17s scheduled in the quarter.

Threshold

The outlier threshold for this indicator is recalculated each quarter and is based on the distribution of rates across contracts for the whole of England and Wales. It is calculated as one and a half times the inter-quartile range above the upper quartile.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

A high band 3 to band 2 ratios may be associated with high rates of UDA per patient. This would suggest that case-mix is part of the explanation, at least. A recent study found high inlay rates to be an important cause in some contracts

Exception Indicator:

Band 1 urgent treatments

Rationale

Unusually high rates of urgent treatments would not be expected, except where the contract was for an emergency dental service. Commissioners will want to understand why a contract had an exceptionally high rate of urgent treatments. Urgent treatments might also be an indicator of failed treatments or a lack of preventative treatment.

Numerator

Band 1 urgent UDA

Denominator

Total UDA

Threshold

The outlier threshold for this indicator is recalculated each quarter and is based on the distribution of rates across contracts for the whole of England and Wales. It is calculated as one and a half times the inter-quartile range above the upper quartile.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

Other indicators of failure such as free repair and replacement and continuations might be of interest here. High rates of urgent band 1 treatments might be associated with high number of Forms per Patient.

Exception Indicator:

Inlay Rates

Rationale

Inlays are a form of indirect restoration of tooth loss, ranging from a small cavity to partial tooth loss. A clinical judgement is required to determine the appropriate restoration for each situation – but there is some evidence that inlays are being used for inappropriately small cavities where a direct restoration would be more appropriate. There is also evidence that the appropriate materials are not always used, sacrificing the permanence of the restoration, for cost.

Inlays attract a Band 3 reimbursement, compared with band 2 for fillings. Where low cost materials are used inlays are the cheapest band 3 intervention available, which could present perverse incentives to dentists keen to maximise their UDA.

It is also known that exempt adults are significantly more likely to be given inlays, than charge payers. Charge payers may be discouraged by the higher patient charge for band 3 treatments, opting for direct fillings instead. Where the inlay rates are exceptionally high, commissioners will want to understand the clinical justification from the dentist and also whether patients are being asked to choose between different restorations on cost grounds

Numerator

Adult FP17s – number of teeth with inlays on claim.

Denominator

Adult FP17s – number of teeth with inlays or fillings on claim.

Threshold

The outlier threshold for this indicator is based on the results of an analysis and investigation in 2010. The outlier threshold is set at 0.20 and the amber threshold at 0.10.

Warning

Values that exceed the configured threshold are marked with the Warning Over.

Values within 10% of meeting the configured threshold are marked with the Warning Near.

Thresholds can be customised by the Support Desk personnel on request.

Cross references

Exceptional inlay rates may be one of the explanations for high UDA per form, and thus high UDA per patient




NHS DAF Alerting Report

The NHS DAF Alerting Report is also available through MyPractice Cloud (MPC).


Background information

The NHS Alert Manager provides a means for practices to setup alerts on NHS policy or service breaches, and to track the data around practice conformance.

Trigger conditions:

The trigger conditions for NHS DAF Alerting are based on NHS requirement specifications approved by the NHS.

In response to a DAF trigger condition a configurable message (unique to to each KPI) displays as a warning. The user who triggered the alert is able to add supporting notes/evidence as to why the action is occurring. The DAF breach action is logged in the database along with the user's supporting notes.

NHS Practices using

...

EXACT can optionally configure

...

EXACT to

  • Report on their DAF KPIs in order to be responsive to their continuous performance.

  • Collate evidence of practice performance against KPIs

  • Alert Providers to any possible actions that could contribute to these KPIs.

DAF Alerting:

NHS DAF Alerting is configurable per practice (not per individual).

Trigger conditions for the alerts are based on NHS requirement specifications and are approved by the NHS.

NHS Practices using

...

EXACT can optionally configure

...

EXACT to

  • Report on their DAF KPIs in order to be responsive to their continuous performance.

    The NHS DAF Report is also available through MyPractice Cloud (MPC).

  • Collate evidence of practice performance against KPIs

    • KPI-related actions are logged and auditable

    • Associated notes are shown on the NHS DAF Alert Report

  • Alert Providers to any possible actions that could contribute to these KPIs.

    • Default messages advise that the current Provider activity is being NHS DAF KPI monitored.

    • Messages instruct the Provider to input supporting notes or evidence.

  • DAF Alerts are configured in the NHS Alert Manager.



To run the NHS DAF Alerting Report

  1. Select Administration > Reports and double-click the NHS DAF Alerting Report.

  2. Specify the report parameters in the Print DAF NHS Alerting Report window:

    PrintDAF-NHS-Alerting-Report-01Image Modified
    • Select Patients: To Search across all Patients, leave the Select Patients box blank, or to filter the search, choose an existing Query Template or alternatively create a new Query Template.

    • Performer(s): Choose the Provider(s) for whom to run the Report - use the Multiple option if necessary:

      PrintDAF-NHS-Alerting-Report-02Image Modified
    • Contract Number: Select the Contract Number against which to run the Report.

    • From/To Dates: Set the period for reporting.

    • Number of Copies: For physical printing.

  3. Select a report output option: Print, Preview, Email or Export.

    The report may take some time to search through the patient selection in order to calculate the results:

    ClinicsOptionsImage Modified


    When the report generates, a Main Heading section displays which parameters were used to generate the Report, followed by column headings and any matching results:

    PrintDAF-NHS-Alerting-Report-04Image Modified

    Date: Actual date on which the DAF Alert Breach occurred.

    Patient: Unique Code and Name of a Patient.

    Provider: Person who charted the COT.

    Breaching COT Columns: The number of the COT that is causing the Alert(s) to be displayed, and the status of that COT.

    Breached COT Columns: The number of the COT that was breached

    Alert Type: Which event type caused the Alert.

    Band 3: A previous Band 3 treatment has been planned/completed, and a new Band 3 COT has been started within the specified period.

    Fluoride Varnish: Patients within the specified Age Range should have this service applied to them when they visit, if they have not had fluoride varnish applied within the specified duration.

    Fissure Sealant: Patients within the specified Age Range should have fissure sealants applied to them when they visit, if they have not had a sealant within the specified duration.

    Alert Notes: If Alert Notes required has been enabled for the alert(s) and notes have been entered, these will display. If no notes have been collected, a Not recorded message displays.


NHS Re-attendance Report

In general, an FP17 submitted for a single patient's new course of treatment falling within 28 days of another course ending, is referred to as 28 day re-attendance.

More specifically, where any Band 1-3 claim follows within 28 days of a previous Band 1-3 claim, for the same patient at the same contract, this is categorised as a 28 day re-attendance claim.

Urgent treatment is not included and neither are patients who attended a different contract within 28 days.

The NHS Re-attendance report is a means for the practice to track compliance to the practice configured guidelines on Re-attendance.

Schedule: This report can be scheduled to be sent by eMail attachment (.CSV Export/PDF format) or printed automatically.


To run the NHS Re-attendance Report

  1. Select Administration > Reports.

  2. In the Reports tab, scroll down to the NHS Re-attendance Report and double-click it:

    OpenRe-attendanceReportImage Modified
  3. Select the parameters for the Report:

    1. Select Patients by means of Query Template:

      PrintRe-attendanceReport-QuerySelectImage Modified
    2. Select Performer or Multiple Performers:

      PrintRe-attendanceReport-1Image Modified
    3. Select a Contract Number by means of the Up/Down arrows or by opening the selection screen.

    4. Select From and To dates for the report.

    5. Specify the number of copies.

  4. Print, Preview, Email or Export in the normal manner.


UDA or UOA Breakdown Report

This report can be run from either the NHS or Reports option in the Administration menu.

  1. Select Administration > Reports

  2. Double-click the UDA or UOA Breakdown report to open the Print UDA or UOA Breakdown window:

    Image Modified
  3. The date range (inclusive) specified by the Contract Start Date and Contract End Date fields is set by the Contract Number, and determines which COTs are included in the report:

    • All NHS courses with a completion date in the range are included.

    • Patient's ages are determined as at the treatment start date.

    • Incomplete COTs are included based on their start date.

  4. The Contract Number determines which patients and claims are included in the report. To select a Contract Number:

    • Type a known number, or

    • Scroll by means of the Up/Down scroll arrows, or

    • Click the List/Select button

      Image Modified

      and choose a Contract from the View NHS Contract Numbers window:

      View PCT Contracts windowImage Modified
  5. Breakdown by Performer: Check (tick) this checkbox for a detailed breakdown of the figures by Performer in the Contract specified, or leave unchecked for a general breakdown.

  6. Click the OK button.

The report runs through all patients and checks to see if they have a course of treatment that matches the above criteria (in the date range and for the providers on the Contract Number). For patients who do not have a matching course, it checks to see if they have one of the contracted providers as their dentist. If they do they are added to the 'not seen' count, using their age as at the end of the date range.

Where a matching course is found, the UDAs for the course are determined, and added to the UDAs claimed count using the patient's age as at the acceptance date of the course.

If the BreakDown by Performer check box is ticked then the rows starting with '-' are shown (if this checkbox is unchecked, they are skipped). These rows are calculated using the more detailed band information found on the FP17.

Domiciliary and Sedation counts are also determined from the FP17.

The patient charge figure is also calculated from the FP17.

NOTE: It does not matter whether the charge has actually been collected from the patient.

Example Report (Summary option)

...

For the Treatment Categories where a quantity is recorded, both the number of claims and the quantity will be shown in each column, for example, "4(6)". The number outside the bracket shows how many COTs included the item. The number inside the bracket shows how many of the items were done. For example, 4(6) indicates that 6 items were done across 4 COTs.


UDA or UOA Report

The UDA/UOA Report shows progress on all NHS contracts held by the practice, grouped by contract or by provider, with or without detail.

Upgraded in

...

EXACT v11.9:

For upgrade details see:

Upgraded UDA/UOA Report, October 2015 - explains the changes.

Re-enabling the older UDA/UOA Report - it is optional to run the previous version report in parallel with the current version.

Scheduling the UDA/UOA Report - you can optionally schedule the new version and / or re-schedule the older version

To Run the UDA/UOA Report:

  1. Either

    • Select Administration > Reports and double-click the UDA/UOA Report:

      SelectUDAReport-1Image Modified

    - or

    • Select UDA/UOA Report from the workspace bar NHS shortcut (if configured):

      SelectUDAReport-2Image Modified

      The print dialogue displays:

      PrintUDA-UOAReport-dialogueImage Modified
  2. To generate a report for the entire practice, leave the Provider(s) field empty.

    To generate a report for an individual, select by means of the selector Image Modified button.

    To generate a report for specific individuals, select the Multiple button and then select individuals from the window by means of CTRL-click. This also allows you to choose whether to print individual reports for each provider, or a combined report.

  3. If you enter a Contract Number, the Contract Start Date and Contract End Date fields will be defaulted, otherwise these will be blank.

  4. The previous version of the report had a Group By field for selecting Performer and Date. These parameters are no longer optional but included by default in the report.

  5. Check (tick) the Show Detail checkbox if you want to show all courses provided by each provider under the contract for the selected time period, with the banding information.

    If you leave it unchecked only UDA/UOA totals for each contract or provider will be shown.

  6. You can also select the number of copies to print, or select a printer, if those options are enabled under Configure > Printing Setup.

  7. Click Print to send the report to the printer, Preview to preview on screen and then print from the Preview screen, Export to export to a *.csv file (for use in a document or spreadsheet), or Cancel to return to the previous screen.

Report Example:

The summary report lines show the following, also broken out by Contract or Provider:

Date Range / Days

The start and end of the date range being shown, and the number of days that this encompasses.

Only UDA/UOA that are relevant to the date range specified will be shown (the previous version of this report showed values for the whole NHS contract date range, irrespective of dates specified).

Provider- Contract Number

The Provider code and Contract number.

Running the report for a single provider will only print a single provider section with no summary sections.

Running the report for multiple providers will print sections for each provider and a provider summary section.

The contract type UDA or UOA is marked on the end.

It is now mandatory to enter a NHS contract number for the report.

UDAs/UOAs TCed

The number of UDA/UOAs totalled by Provider or Contract.

Target

The target number of UDAs/UOAs for the elapsed period of the contract

% Target

The number of UDAs/UOAs achieved so far, as a percentage of the number targeted over the same period.

This is calculated using Claimed amount / Target.

If the Target value for any row is 0, the % Target column will show N/A.

Note that the Claimed and Confirmed columns are no longer adjacent.


The detail lines if present show,

COT Number

The COT number is shown in the column to the left.

Date

The date of the course is shown in the second column.

Patient

The name of each Patient treated.

UDAs/UOAs TC'ed

The number of UDA/UOAs for each course is shown in the fourth column, totalled by Provider or Contract at top and bottom.

Banding

The banding of the Treatment


...


Note that if any UDAs have been transferred from another provider, the details will appear at the end of the provider's details, as shown below:

...

In this example, 4.00 UDAs were transferred, for COT41327.


UDAs In Progress Report

The UDAs in Progress report selects all open NHS courses for one or more specified providers, and produces a report with details as follows:

  • NHS Courses with no further planned work

  • NHS courses with no future appointments

  • Other open NHS courses

  • Totals for the above.

For each of these, the patient names, courses of treatment, last appointment date and the UDAs or UOAs are listed.

To run the UDAs in Progress report

  1. Select the Report:

    • Click the UDAs in Progress button in the UDA Manager screen

      - or -

    • Select Administration > Reports > UDAs in Progress Report

      - or-

    • Select Administration > NHS > UDAs in Progress Report

    The Print UDAs in Progress Report window displays:

    Print UDAs In Progress Report dialogImage Modified
  2. Select Providers:

    If you've clicked the UDAs in Progress button in the UDA Manager screen, this field will be defaulted from the UDA manager, and will display the code of the selected Provider.

    Otherwise, you can enter the code of a provider, or use the Multiple button to choose more than one provider code, or leave the field blank to include all providers.

  3. Show Detail: Check (tick) this checkbox to include details on the report, otherwise only summary totals will be shown.

  4. Select Print, Preview, Export or Cancel.

Report Example (no Detail option)

...


UDAs Overpaid Report

When the “Overpaid UDAs” report is run it will ask for a range of COT numbers:

...

The default values for the COT numbers are from 0 to the highest on record, but you can overwrite these if required.

Set the appropriate printer details, then click Print, Preview or Email as required.

For each COT the report will check to see whether the Number of UDAs Claimed is less than the the number of UDAs paid, and wherever it finds a course where this is the case it will print it out. This gives a list of all the courses that have been resubmitted back to the chart or deleted, or where you have asked for the UDA amount to be reduced, but NHS Dental Services has not yet sent through the lower payment.

Report example:

...

Each line will show:

  • Date of Transmission

  • COT number

  • Patient Name

  • Amount Claimed for UDAs/UOAs

  • Paid Amount.