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Reviewing the Payment Schedule List

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  1. From the ‘Administration’ menu select the NHS sub menu, then choose ‘Payment Schedules…’
    The dialog window shown below will appear:

     

    Each time the List of Payment Schedules is opened a prompt will appear to specify a date range. Schedules received during this date range will then be displayed in the list. The date range defaults to the previous 3 months, but may be changed as required. A particular dentist’s schedule can also be viewed.

  2. Enter a date range or accept the default dates.

  3. Enter a dentist or leave blank to view all dentists’ schedules.

  4. Click the ‘OK’ button and EXACT may take a few moments to display the list. On completion, a window similar to the following will appear:

     

  5. The ‘Payment Schedule List’ window has the following columns of information:

Schedule

The Schedule number.

Date

Schedule Date.

Provider

The provider to whom the Schedule relates.

PCT Contract Number

This shows the PCT Contract number for the provider.
(England and Wales only)

Contract Number

This is the number of the individual Provider’s contract with the NHS.

DSD UDA/UOAs

This column shows the contracted UDAs/UOAs.

DSD Patient

The Patient Amount, the patient contribution for all Claims within a Schedule, according to NHS Dental Services. This should match the Patient Amount shown in the paper schedule.

Net Paid

(Scotland and Northern Ireland only)

If you are in Northern Ireland and Scotland this will display the total contributions you received from the board and your patients.
In England and Wales this column will not be displayed for treatment provided after 1st April 2006 since NHS Dental Services no longer pay fees.

EXACT
UDA/UOAs

The details in this column are not transmitted in the schedule reconciliation EDI files so they will not be automatically reconciled. The information is contained in the paper schedule to allow a manual reconciliation.

EXACT Patient

This is the Patient Amount (the patient contribution for all claims within the schedule) that EXACT has calculated.

UDA\UOAs Difference

If you are in Northern Ireland or Scotland this will show the amount that you still need to reconcile.
If you are in England and Wales this column should not show a value for treatment provided after 1st April 2006 since NHS Dental Services no longer pays fees.

Patient

This amount is calculated by determining the band for the most recent claim for the course and then applying any schedule adjustments for the course to that value. The value is the difference between the EXACT Patient amount and NHS Dental Services Patient amount.

 

  1. The Payment Schedule List window also has the following controls:

 

(Scotland and Northern Ireland only)

Process the NHS Payment .
This allocates the NHS BACS payment to the Invoices on the schedule. This should only be done after checking the schedule and adding any negative items (see section on Negative Items). Once a schedule has been processed the open amounts in the List COT screen will decrease.

 

(Scotland and Northern Ireland only)

This button reverses the Process Payment , and will be 'greyed out' (unavailable) unless you select a schedule which has previously been processed.

 

This button allows access to a different schedule, rather than having to go back through the menu.

 

Edits the current payment schedule. Alternatively double-click on a schedule.

 

Review Payment Schedule Detail

  1. Double-click on any schedule (or click the

    button when a schedule is highlighted) to display the ‘Payment Schedule Detail’ window similar to the following example:

     

  2. The Payment Schedule Detail window has the following columns of information:

  3.  

 

The checkbox allows an entry to be ‘checked off’ so that it disappears from view. You can still gain access to these items by selecting the ‘Only Show Differences’ radio button at the bottom of the screen.

Name

This is the patient’s last name and initial.

D.O.B.

This is the patient’s date of birth for reference.

Sex

This is the patient’s gender (F or M), for reference.

COT

The course of treatment number.

 

 

If the COT has been resubmitted, a  will be displayed in this column.

 

 

If the patient has an Exemption, a  icon will be displayed in this column.

 

 

 

If a Claim Note has been created and saved against this COT, a  icon will be present in this column. Hover your mouse cursor over the icon to read the note. Right-click on the line and select "Add Note" from the drop-down menu to add a note or read or edit an existing note.

DSD UDA/UOAs

The number of UDAs and/or UOAs claimed from NHS Dental Services.

Patient

The amount that NHS Dental Services has determined that patient should pay. If amount is on same line as Scale Fee - the patient has to pay. If on lower line then the patient is exempt and this is merely an indication of what the patient charge would have been.

EXACT UDA/UOAs

This is the number or UDAs or UOAs that have been claimed for this COT.

Patient

The Patient Charge for this COT as calculated by EXACT.

Difference UDA/UOAs

This is the number of UDAs or UOAs that were credited for the work, and applies only to England and Wales

Patient

The difference, if any, between NHS Dental Services and EXACT Patient Charge

(Comments)

 

These are comments from NHS Dental Services and will match those shown on the Paper Schedule. They may provide clues as to the discrepancies in amount paid vs. amount claimed.

 

  1. Double-click on any line in the Payment Schedule to open the ‘View Courses of Treatment’ window, with the details for the current COT displayed.

  2. At the bottom of this screen you have two radio buttons: one called ‘Show Only Differences’ and the other called ‘Show All’. When you have ‘Show Only Differences’ selected this will display those claims that are discrepancies and that you may need to resolve with the board. If you accept the discrepancy and you have made any necessary adjustments you can tick the box to the left of this claim. This claim will then disappear from this view.
    If you select ‘Show All’ then this will display all of the claims included in this schedule.

  3. With all details showing, the ‘Payment Schedule Detail’ window has the following controls:

 

Open the View COT window. Further information about a claim may be obtained here. Alternatively double-clicking on a claim will produce this window also. The View COT window is covered in detail later on in this tutorial.

 

Print a List of Payment Schedule Items, option to include or exclude resolved claims. It is not necessary to print this report in order to complete the Schedule Reconciliation.

 

Click this button to view, edit or create claim notes for a course of treatment.

 

Dispute the amount paid by returning the claim to the Patient chart for amending.

 

View the FP17 Form for the claim.

 

Accept a difference (between amount claimed and paid patient amount).

 

Add a Negative Item. These items are shown on the printed schedule but not transmitted in the electronic schedule.

 

Delete a previously added Negative Item.

 

Edit a patient record.

 

Deleting Transmitted COTs

If you delete a Course of Treatment that has been resubmitted to the chart, even though that course of treatment has already been transmitted to NHS Dental Services, this can cause a problem when trying to work out end of year UDA values. This is because NHS Dental Services will have paid UDAs for the COT whereas EXACT will not be expecting the payment.

This problem is resolved within EXACT as follows:

  1. COTs that have been transmitted are now prevented from being deleted. If you no longer wish to claim for a course that you have previously sent to NHS Dental Services, you must send it back to NHS Dental Services with an observation that explains what you want to happen.

  2. There is a report - “Overpaid UDAs” - that identifies where a course has been resubmitted to the chart, but not re-sent to NHS Dental Services.



COT Status

Each NHS Course of Treatment has one of the following statuses set within EXACT: Planned, TC'd, Transmitted, Confirmed, Disputed.

The status of Disputed is assigned to a COT when it has appeared on a schedule but the number of UDAs assigned differs from what is expected. If you mark the disputed claim as ‘Accepted’ by ticking the schedule line, then its status will become Confirmed. Even though the UDA allocation from NHS Dental Services has a status of Disputed, the UDAs received are still real, so they are counted as confirmed UDAs everywhere in EXACT.

The Confirmed status occurs after a claim has been received on a schedule in EXACT and the UDAs match or you accept the difference.

You can view the status of a COT on the ‘List COTs’ screen, in the ‘COT Status’ column. This column is sortable, with COT number as the secondary sort order. A second column - the ‘Confirmed UDA/UOAs’ column - on the ‘List COTs’ screen shows the confirmed number of UDAs allocated to the course:

 

Claim Notes and Quick Notes

On the Schedule Reconciliation screen (Administration > NHS > Payment Schedules) and on the List COT’screen (Administration > NHS > Courses of Treatment) you can access a button and right-click menu option, called Claim Notes.

 

This allows you to add notes relating to the COT, specifically about UDAs and any steps being taken to track them.

Right-click a selected COT line and select Claim Notes from the right-click menu to display the Claim Notes window:

 

Features of the Claim Notes window

The Claim Notes facility has full audit history: the note may be modified by users with appropriate security settings, but each change is recorded separately and annotated with the date, time and User ID of the person who created or modified it:

Entry Date

This shows the date on which this note was created.

Entry Time

This shows the creation time.

Creator

The login name of the person who created the note.

Modified Date

If the note was modified, this shows the date this occurred.

Modified Time

The time the note was modified.

Modified By

The login name of the person who modified the note.

Note

The first part of the note text (as much as can be displayed in the column).



Any claim notes added to a COT can be printed via the “Include Notes” option on the Print List COTs dialog. (Administration > NHS > Courses of Treatment > Print Button). Selecting this option will print the Claim Notes text on a line below the COT, for any COT that has a note.

A tab called “Claim Notes” is available in the ‘View Course of Treatment’ window (Administration > NHS > Courses of Treatment > i button). It will display the date the claim note was created in a Date column, the user who created it in a Creator column and the note details in a Note column. The tab will be ticked if it contains a claim note and the appropriate buttons (i.e.,

) will be available when this tab is selected. It will operate as described below.

Buttons and Functions

 

This button displays the full text of the note in “read only” form (i.e., it is unable to be edited).

Click this button to edit the text of the note. This will launch the ‘Edit Claim Note’ window (see below).

 

Click this button to launch the ‘Add Claim Note’ window, allowing you to create a new note (see below).

 

This allows you to delete the current note, after displaying an “Are you sure you wish to delete this claim note?” warning. This button is disabled when an audited version of a note is highlighted; only the latest version may be deleted.

After a note has been deleted, it can still be viewed via the “Show Audit”feature.

 

Each note is displayed in only its most recent form, unless this checkbox is ticked, in which case all versions will be shown, including deleted notes, as in the example above. (If not ticked, deleted notes are not viewable).

 

This button enables you to change which columns are displayed, and in what order.



To create a Claim Note

The Claim Notes function is available on

  • The Schedule Reconciliation screen (Administration > NHS > Payment Schedules) and

  • The List COT screen (Administration > NHS > Courses of Treatment).

  1. Access it as follows:

    • In the Payment Schedules window, by double-clicking a schedule to select it, then right-clicking a line item to display the submenu:

       

    • In the Courses of Treatment window by clicking on a patient name to highlight a COT, then right-clicking to display a submenu:

       

  2. In both cases, select the Add Note option from the submenu, to open the Claim Notes window:

     

  3. Click the

    button to add a new note:

     

  4. In the Add Claim Note window, you have the following options:

    • You can begin typing the note text immediately.

    • You can click the

       

      button to create a new Quick Note.

    • You can select an existing Quick Note in the right-hand pane, and click the

       

      button to add the Quick Note to the left-hand pane. It can then be added ot or edited, if required.



Quick Notes

Use the Quick Notes facility to create pre-written notes for actions you are frequently taking with respect to COTs, or notes that you find you are commonly making.

Initially there are no quick notes set up, but they can be created at any time.

Once you've created Quick Notes you can then add them as Claim Notes and edit or add to the pre-written text as you use them.

To add Quick Notes

  1. To add a Quick Note, click the

     

    button in the ‘Add Claim Note’ window; this will display the ‘Add Quick Note’ window:

     

  2. Type a brief description in the Description field; this will identify the Quick Note when in the ‘Add Claim Note’ window.

  3. The Type field is used if you wish to set up commonly used Quick Notes into separate categories. You can view and select from the types by clicking on the

     

    button.
    If there are no types set up, they can also be added or edited via this button.Once types have been created, they are also accessible via the

     

    button.
    (This is an optional field, and may be left blank if you do not wish to use it).

  4. Type in the body of the text in the Notes field, then click the

     

    button to save the details, or the

     

    button to exit from the window.

 

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