England

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.

Double-click on a selected schedule to view the ‘Schedule Details’ screen. If there are any differences, these will be immediately visible. 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Often NHS Dental Services have returned a UDA amount of zero, with a comment of “Claim Withdrawn”.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 decision in these cases. To help you decide 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

1. Select Administration > NHS > Payment Schedules.

   Open

   

    

   EXACT will ask you to select Date range and Dentists:

   Open

   

    

2. 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).

3. 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.

4. 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.

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.)

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.

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:

• Band

• Contract

• Provider (optional)

Northern Ireland

To reconcile your electronic NHS schedules through EXACT

1. Select Administration > NHS > Payment Schedules.

    

   EXACT will ask you to select dates and providers:

    

2. 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).

3. 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.

4. 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:

   1. If you agree with the difference, click the Adjust button to auto fill the information, then click OK.

   2. If you wish to re-send the claims,

      i) Resubmit,

      ii) Make any amendments,

      iii) TC and transmit again.

      If the Board pay the full amount, the difference will be paid on the next schedule.

5. Once you have dealt with the differences, click the second X down in the top right hand corner of the screen to return to the main Payment Schedule List screen.

6. Click Process Payments to automatically allocate the Payor payments to each of the patients to show that you have been paid by the dental Board

7. Repeat this process for each Provider's schedule.

   ASSISTANCE: If you require any assistance, please contact Support on 0845 345 5767, where a member of the team will be happy to assist.

Scotland

You will receive NHS Schedules once a month, and you will notice they come in when you transmit.

To reconcile your electronic NHS schedules through EXACT

1. Select Administration > NHS > Payment Schedules.

    

   EXACT will ask you to select Date range and Dentists:

    

2. Select a Dentist or, to do the most recent for all Dentists, leave the screen as is.

3. Select OK to display the Payment Schedule List with a list of schedules, with dates and schedule numbers that relate to the paper version.

4. Double-click the schedule that you wish to check to display differences on the screen.

   If it is blank, there are no differences. 

   If it has entries:

   1. If you agree with the difference (which you can check by double clicking), click the Adjust button at the bottom.

      This will adjust the amounts on the system, and you are accepting what the board has paid you.

   2. If you disagree with the difference, you cannot resend the claims through EXACT; you will need to ask the PSD for 283 Adjustment Forms. They can advise on how these should be done. The forms have to be sent by paper.

5. Once the differences have been dealt with, by adjusting it will auto tick, but if you disagree, tick the box on the far left. 

6. Once empty, the schedule has been dealt with and you can finalise as follows:

   1. Close the screen by means of the small X at top right, to return to the Payment Schedule List screen.

   2. Highlight the schedule you have just completed and click Process Payments on the bottom left.

   3. This will clear the open amount and tick the box on the far left.

   The schedule is now processed.

   If a response has come back but is not part of a schedule, you can re submit and resend.