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| This field determines the payor. Use the | |||
| The ‘Name’, ‘Address’, ‘Phone’ and ‘Fax’ fields are optional, but allow details to be entered for the payor if required. These will appear on the claims for information purposes only. | |||
| The ‘Use Fees of’ field is used to cross reference the payor’s fee schedule with the payor name. It is possible to have multiple payors sharing Fee information. The NHS payor has its own special Fee’s and should not be using the Fees of any other payor, soleave this field blank. | |||
| The set colour button is used to choose a unique colour for Treatment plans for this payor. If the default colour is not suitable, click on the button and make an appropriate selection. | |||
| The ‘Inactive’ checkbox can be ignored when setting up the ‘Payor File’, but is used later if a payor becomes inactive. | |||
| The NHS Fee information determines both the Overall Fee for a Service and the portion of the Fee the payor will cover. | |||
| The ‘Pass Costs on to the Patient’ checkbox does not apply to the NHS, | |||
| This is the total of unpaid invoices to the NHS. This figure includes open Courses of Treatment and therefore does not reflect the Claimed amount currently outstanding. | |||
| The NHS operates across the UK with variations to the NHS system in certain regions. The option displayed in the box will be for your region. If the box simply displays NHS without a region it is configured for England and Wales. | |||
| This is the % of total charges the payor will contribute towards the Fee. This is used to determine the Patient/NHS split when entering a Fee for Assessed Services. | |||
| The field and controls below ‘Patient Limit’ are used to annually update the ‘Approval Limit’ and ‘Patient Limit’ fields. A record of what the amounts were in previous years is also maintained so that claims either side of the annual cut-off date can be managed. | |||
| The ‘Fee Schedule’ button opens the Fee Schedule window that contains the pricing and rules and regulation information for the NHS Services. | |||
CAUTION: Authorisation should be obtained before making any changes, because these could cause incorrectly priced Claims being sent to and rejected by the DPD, resulting in financial loss to the practice. | ||||
| The ‘Claim’ button allows TC’d Claims to be Bundled for transmission to the NHS Dental Services. | |||
| The ‘Transmit Claims’ button transmit all Claim Bundles not previously transmitted, to the DPD. | |||
| The ‘Transmit Setup’ button opens a wizard to configure the mailbox, modem, and other connection details during initial system setup. It also contains a tool for testing the communication to the mailbox in case of a problem. | |||
CAUTION: There should be no need to use this button after the system is installed if everything is working correctly. | ||||
| The ‘PDS Setup’ button is used only when setting up the PDS contract within NHS, and will otherwise be 'greyed out', as shown here.. | |||
| Clicking on the
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NOTE: Software of Excellence will normally notify you if there are any changes to NHS Bands Setup. Otherwise, there should not normally be any need to alter these settings. If you amend these details without prior notification from SOEI then you could risk charging some items incorrectly. | ||||
The ‘Bands Setup’ button opens the following window to edit the patient fee and UDA value of NHS claim bands for that Band Date.
Change the band date by clicking the drop-down on the 'Date' button. To load new band info for another date, click the
NOTE: The patient fees shown are for England . Those for Wales are as follows: (UDAs subject to Ortho completion) and as of 2011. For the current fee's please speak with the NHS. Double-clicking on an item, or highlighting it and clicking on the
To download a new set of fees, click the Note that you must have an active connection to the Internet to complete the download. | ||||
NHS Northern Ireland |
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NHS Scotland |
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NHS England / Wales / Isle of Man |
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The options above control the way that the NHS claim forms are handled by EXACT. Click the appropriate option(s) for your site. | ||||
Click the "Set Print Offsets" button to adjust and test the printing for the FP17 and FP17O forms. This will display the following dialog:
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Choose the appropriate form type, then click the "Test Print" button to see how closely the printed information fits the form. If it is not aligned properly, enter appropriate X and/or Y offsets and retest, repeating until alignment is correct. Click the | ||||
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NHS Scotland Changes 01 April 2016
Applies to Scotland only.
If the following services are used after 1 April 2016 they are no longer considered for prior approval costs:
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This limit only applies to some services, whose charges are totaled when they occur in a single Course of Treatment (COT). The charges of other services in a COT are not considered towards the limit.
EXACT flags all treatment services in the COT when the limit is exceeded and Prior Approval is required.
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The first step towards transmitting Claims is to create Claim Bundles. EXACT requires that individual Patient Claims be combined into Claim Bundles for each provider before being transmitted.
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The first step towards transmitting Claims is to create Claim Bundles.
EXACT requires that individual Patient Claims be combined into Claim Bundles for each provider before being transmitted.
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- From the ‘File’ menu click ‘Payors...’, select the NHS payor, and click on the
button; the “NHS Claim” window will open as shown below:
- If all TC’d charges are to be Bundled, click the
button and select all NHS dentists. - The ‘Date to’ field will have defaulted to the current date, so that all charges for the selected dentists will be included in the Bundle.
- Click ‘OK’. A prompt to enter a PIN number may appear:
NOTE: EXACT can store the dentist's 6-digit PIN within their Provider File, on the "NHS Details" tab. If the PIN is not entered there, you will be prompted for it every time the Claim button is clicked.
- EXACT will now create the Claim Bundle(s).
NOTE:A Completion Bar will be displayed to indicate progress. The length of time this takes varies. As a general rule the process is very quick if Claim Bundles are created regularly (e.g. every day), and slower if transactions have been allowed to accumulate before Claiming.
- Once the Claim Bundle(s) have been created the option to print the Claim Summary will appear a shown below:
- Click the ‘Print Claim Summary’ button to print or preview the report as shown below, or click the ‘Done’ button to move onto the transmission process.
- Claims can now be transmitted to NHS Dental Services.
Claim Messages
EXACT may display the following messages during the Claiming Process:
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Each time a connection to the Mailbox occurs EXACT will check for new messages. Claim Bundle Acknowledgement messages will be processed and the Claim Bundle Status updated as appropriate.
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Transmitting Claims
Transmitting connects EXACT to the mailbox. Once connected two processes occur:
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A claim bundle does not have to be of any particular size, it can contain only one claim if necessary. It is simply a way of EXACT preparing the files to be transmitted.
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- If any calling or remote control programs such as PC Anywhere are running and waiting for a call, cancel these and close the programs.
- Exit EXACT and login again.
- If the modem uses a shared telephone line it is advisable to either turn off or disconnect any faxes, EFTPOS systems or other devices that may use the phone line.
- From the ‘File’ menu click ‘Payors...’ and select the NHS payor.
- Click the Transmit Claims button
.A window will appear to select the date range.
- Amend the dates if necessary then click 'OK' to confirm.
- The transmission progress screen will appear and EXACT will connect to the mailbox.
- The status of the call will be displayed, similar to the example shown below:
- The ‘Progress’ area displays the progress of the transmission
- The 'To Send' section of the window displays the name of the bundles being transmitted to NHS Dental Services. Once the file has been sent to the board a tick is placed in the 'Sent' column.
- The ‘Response Files’ area displays files received from NHS Dental Services.
- A progress bar will appear to indicate the length of the transmission. Once a transmission has been completed the following screen will appear:
- Click on the ‘View Responses’ button to be linked directly to the Response screen. The ‘View Schedule’ button will link directly to the schedules. Alternatively you could choose to close the screen and view the responses or schedules later by going to ‘Administration’, selecting 'NHS' and choosing the relevant item, or click the
button in the UDA Manager screen..
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- If you are transmitting claims via the internet, you can check your internet access by opening your internet browser (Internet Explorer, Firefox, etc.)
- PC Anywhere or some other Computer Communication Software program that takes control of the modem may have been left running. Exit EXACT, and login again if this is the case.
- Check all cables are connected correctly and equipment turned on.
- If the modem is external, check the indicator lights.
- Disable any other equipment that shares the same telephone line.
- Plug a phone into the telephone line and test that a number can be dialled. If the phone line does not appear to be working, contact British Telecom Faults.
- Call Waiting should not be enabled on the modem telephone line as this is known to interfere with transmission.
- If for any reason the modem is replaced or reinstalled, the communications (COM) port setting should be kept the same as it was. If it is not possible to retain the COM port setting, the new COM port will need to be entered into EXACT.
To set up a COM Port in EXACT
- From the ‘File’ menu click ‘Payors..' and select the NHS payor, then Click the Transmit Setup
button. This will open the NHS Transmission wizard. - Follow the instructions in the wizard until the ‘Transmission Set-up’ ‘Modem Set-up’ window opens.
- Click on the ‘Re-Detect Modem’ button.
- The transmission speed is typically set to 9600, although some Global Crossing Phone Lines transmit at a slower speed. Refer to your original documentation from Global Crossing if unsure of the correct transmission speed.
- Complete the instructions in the wizard and choose ‘Finish’.
- The connection should be tested after making changes by using the ‘Test Transmission Set-up’ button.
To test the Connection:
EXACT has a built in Connection Test Tool. This tool will ring Global Crossing and connect to the mailbox, without sending or receiving files.
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