Transmitting NHS England Claims

Before completed work can be transmitted to NHS Dental Services for processing and payment, they must first be placed into a claim bundle which prepares the files for EXACT to transmit. Consider it as, all of the electronic FP17 forms being placed into an electronic envelope for posting.

A claim bundle does not have to be of any particular size but can only contain a maximum of 90 COTs per bundle, it can contain only one claim if necessary.

To create a claim bundle

1. Select File > Payors : NHS or PDS from the list to display the Payor File, from where you can set up a shortcut on the Workspace.

2. Select the Claim button.

   Open

   

   A window will appear prompting the user to enter the provider(s) and up to what date would they like to claim.

   Open

   

3. Select either a single or multiple providers to be bundled into this claim. The date box defaults to today’s date but can be altered if required (although backdating this will mean claims will be missed).

4. Click OK and the user will be prompted to enter each Provider’s six-digit PIN (Personal Identification Number).

   NOTE: It is possible to store each PIN against the appropriate provider; to do this go to the Provider File and enter a PIN within the NHS Details tab. If PINs are stored the above screen will not appear when creating a claim bundle.

5. Once the PIN is entered and you click OK, the bundle is created.

6. The option to print a claim summary is available, if required. Otherwise, click Cancel.

7. If you have not printed a claim summary, it is possible to do this at a later date by viewing and printing the individual claim.
   To do this, click Administration then 'NHS' and 'List Claim Bundles'.
   From here double-click on the claim to view the names of the patients and the amounts being claimed. Alternatively use the print claim button at the bottom right hand side of the screen.

To Transmit Claims

Once you have bundled your claims you will see a box which prompts you to transmit. If you are ready to send the claims off select OK and the bundles created will be sent to the board.

If you do not transmit when you put the claims into bundles you will need to follow the steps below:

1. Select File > Payors… and select the NHS payor.

2. Click the Transmit Claims button.

   A window will appear to select the date range.

3. Amend the dates if necessary then click 'OK' to confirm.

4. The transmission progress screen will appear and EXACT will connect to the mailbox.

5. The status of the call will be displayed, similar to the example shown below:

   1. The ‘Progress’ area displays the progress of the transmission

   2. 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.

   3. The ‘Response Files’ area displays files received from NHS Dental Services.

6. A progress bar will appear to indicate the length of the transmission. Once a transmission has been completed the following screen will appear:

At the end of every transmission you should check Responses (Administration > NHS > Responses) to deal with any possible rejections.