NHS Triage Claims

EXACT Version Required: EXACT V13.250 - Region: England Only

NHS Triage claims can be submitted to the NHS via EXACT. This data will be submitted via a new service called ·TRIAGE which will be available in your service list. This feature will only activate on 1st December 2020. If you try and chart the ·TRIAGE service before this date you will be met with an error message blocking the service from being used.

You can either chart this service directly onto an NHS Course of Treatment, or use the Triage button from the Arrivals tab/list, which will chart the service for you, from the Appointment book.

FAQ’s

https://soeidental.atlassian.net/wiki/spaces/PHS/pages/1178501397/NHS+Triage+Claims+-+FAQ+s

Video Demonstration

Configuration

There is a configuration option to choose when to check NHS Triage if its less than X number of days with the default being to 2. This can be set under Configure->Appointment Book->Arrival Options

This setting will indicate if a patient requires a triage record, on the Arrivals tab/list. A black icon will show no triage record exists for the previous 2 days. A green icon shows the patient has been triaged. These icons will display for appointments booked with a NHS payor.

The Triage button will launch the triage form, where you can select if you are conducting an initial triage, or a triage record for a patient attending the appointment (in treatment triage). On form completion, a ·TRIAGE service will be added to the patient’s chart.

Initial Triage: This should be selected if a triage call does not result in an appointment or the patient FTAs.
In Treatment Triage: This should be selected for any triage call where the patient attends for treatment.

The Triage date will default to today's date but can be backdated if required. The triage time should be set to the time the triage call ended. Fill in the form using the tick options and drop down boxes and click OK.

Charting a Triage Claim

The ·TRIAGE service can also be charted from the patient’s chart.
Create a new NHS Course of Treatment for the patient.
Chart the ·TRIAGE service which can be found in the service list. It will appear under your Favourites category, if you have one configured. You can always modify, or add it to a different category if necessary.

Once charted you double click, or tick the Triage Assessment service as complete, to display the form. You can choose initial triage or in treatment triage as mentioned previously.

Submitting a Triage Claim

When you TC a COT you will have 2 options. If the Course of Treatment contains an EXAM or other treatment items in addition to ·TRIAGE services, then it will be the regular TC screen but will contain a new tab with their Triage information.

If you send a claim that only contains an Initial Triage Assessment then EXACT will display a ‘Send Triage Claim’ window. Select the Performer and Contract, choose whether the patient FTA’d and click Send Claim.

Warnings

If a user adds a Triage Assessment service, with an ‘In treatment’ triage option and does not include any treatment services, the below warning will appear on TC. ‘In treatment’ triage records need to be sent as part of normal FP17 or FP17O claims.

 

If a user adds multiple ·TRIAGE services including ‘initial’ and ‘in treatment’ options, without treatment, the below warning will appear on TC. If the patient never attended the practice, the Triage claim can be sent by selecting Continue. If the patient did attend, then treatment needs to be added to the Course of Treatment, so that the triage records can be sent as part of the normal FP17 or FP17O claim.