List Courses of Treatment Window

The List Courses of Treatment screen is accessed from the Administration menu (Administration > NHS > Courses of Treatment) and is a useful tool that allows you to view details of current course of treatment for your patients.

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Column	Details
COT	The COT number. Click on the column heading to change sort order from ascending to descending or vice-versa.
Open	If there this icon in this column, it means there is a Claim Note for this course of treatment. To read it, hover the mouse cursor over the icon to display it as a tool-tip, OR double-click the COT line to open the View COT window, and select the Claim Notes tab.
Open	If the COT prompted the NHS Re-attendance alert and notes were entered this icon will show. Hovering over the icon will show the notes.
Open	This column has an icon in it if the course is a prior approval. The colour of the icon shows the approval status. Yellow is in progress, Green is approved, Red is not approved.
Open	The Treatment Completion column shows one of three status icons: COT still open, Treatment completed and Transmitted (Phone icon).
Provider	This shows the ID of the provider who treated this patient.
Patient	The patient’s name.
Xmitted	When the COT claim has been transmitted to NHS Dental Services, the date is recorded here.
Payor	The payor for this Course of Treatment (NHS or Private).
Amount	This displays the amount payable for the COT.
Payor open	The amount still payable by the payor.
UDA/UOAs	The number of UDAs or UOAs for the COT will be displayed here.
Patient open	The amount still payable by the patient.
COT Status	The current status of the COT is displayed in this column.
Confirmed UDA/UOAs	The total confirmed UDAs/UOAs are displayed here.

Functions/Features in the List COT Window

Course of Treatment Details

To view the details of any COT, simply double-click the required COT line, or click the button when the required COT is highlighted. This will display the ‘View Course of Treatment’ window, as in the example below:

There are four tabs on the ‘View Course of Treatment’ window: the first is the Payor Transactions, as above, which displays the transaction details for the COT that apply to the payor.

The Patient Transactions tab shows the transactions for the patient :

The Charting tab shows the actual charting details for the COT:

The Claim Notes tab shows any notes that have been made against the COT claim, and allows you to add new ones:

See the Claim Notes topic for more information about this tab.

Functions

NHS Service Codes & Categories

EXACT may still display payor codes for a quick way to find certain English/Welsh NHS service codes, however, the NHS no longer require these specific payor coded services to be used. The NHS now require the service codes to contain the relevant “FP17/FP17O Clinical Dataset”. So any service within EXACT can be used for NHS treatment and those services used with a clinical dataset assigned will get included in the FP17 data that is transmitted to the NHS.

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Keeping your NHS service codes within service categories like “Favourites” or “NHS Favourites” is the best way to make sure you use the correct codes that are already mapped to the correct Clinical Datasets.

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Charting NHS Patient Treatments

Enter and Complete NHS Non-Orthodontic Treatment

1. Create a Course of Treatment normally in the Chart tab, completing the Exemptions and Charges screen that displays in the process, or selecting the Exemption button to display this screen:

   > See Exemptions and Charges screen

2. When complete, select TC (Treatment Complete).

   ... and complete the NHS FP17 screen that then displays

   In the process,

   • If applicable to your region, complete the DMF (Decayed, Missing, Filled).

     You'll be prompted each time by an EXACT popup window to check these DMF scores. (You can optionally disable the prompt)

     > See DMF (Decayed, Missing, Filled) for details.

   • If applicable to your region, complete the Universal Credit Exemption

     > See Universal Credit Exemption for details.

To chart an Urgent Treatment

NOTE: If the treatment is ‘Urgent’ such as a temporary crown to replace one that has been lost, and the repair is combined with other treatment, EXACT will display a warning symbol with the item to advise that the repair will earn fewer UDAs than if the treatment was charted separately, as shown below:

1. The user has the option to override this by making all treatment items in the course ‘Urgent’. To do so, double-click on each of the other items in the course, and change the band type in the top right hand corner of the ‘Edit Chart Item’ window to ‘Urgent’, as shown below:

2. Continue to add service items until the treatment plan is complete.

To chart a Free Replacement

1. If any treatment is for a free item, double- click on that item to open the ‘Edit Chart’ Item window, and check the ‘Free Replacement’ box as shown below:

   In the example of the free replacement of a metal cap as shown below, this will remove the patient charge of ₤42.40 for what would have been a Band 2 treatment, while retaining the 3 UDAs the dentist would normally earn for a repair.

2. Review any other alert symbols and action accordingly.

3. Tick each service/appointment as it is completed.

4. Click the ‘Charge’ button at the end of each visit.

5. When the Course of Treatment is completed, click the 'Treatment Completed' button.

6. In most cases EXACT will enter the appropriate details on the FP17 form. However, there are some fields that will require your attention.

7. Click the FP17 tab to view and/or print the FP17 form.

   You can view the FP17 form by either clicking the button, or double-clicking the FP17 thumbnail. Either option displays the FP17 form so you an check the patient's data has been entered correctly.From the display you can view the other page of the form and print it if required.

   The button also allows you to print either the front, back, or both pages of the form.

   As this is merely a view of the form (not “form emulation”), you cannot send the claim from the form itself, but must use the Send Claim button on the NHS FP17 window.

8. Click the Claim details will await transmission to the NHS Dental Services, and the patient will be invoiced for treatment.

9. If any Mandatory Patient or claim details are missing a warning message will appear. Continue until the missing information is entered and saved.

10. The Course of Treatment will be removed from the Current Course of Treatment Area and placed into the Treatment History window.

Exemptions and Charges

Provided you have the Auto Create COT enabled in Configure > User Settings, you can double- click on an NHS service item to create a course of treatment. As long as the patient's Details tab has NHS payor, EXACT will create an NHS course and display the Exemptions and Charges screen shown below.

If you are an activated NHS Pilot practice, you can also create an NHS course of treatment by means of the NHS Treatment Plan Types.

Alternatively, clicking the button to create a new NHS course of treatment will also activate the ‘Exemptions and Charges’ window. Completing this form will ensure that for Exempt or Partial Remission patients, the Course of Treatment created displays the correct patient fees.

England and Wales example:

Note that there are two different forms displayed - one for patients over 18 years of age, and another (with fewer fields and options) for patients under 18. The children's form is lower on this page; the following is the adult's example.

Some of the boxes may be greyed out. This indicates the option is not applicable to the patient. For example: no under 18 options available if the patient is over 18; male patients will not have the pregnancy/baby options.

When marking a patient's exemption follow the guidelines below:

• For the Patient/Partner options, the Supporting Details text box becomes available when one or more of the Patient/Partner options is selected. You can then enter relevant information (such as the partner's name if the exemption relates to the partner).

• Partial Remission Limit: When the Parent/partner has HC3 certificate option is selected, the Partial Remission Limit box becomes available. Here you will need to enter the Partial Remission value, and in the 'Supporting Details' you will need to enter the HC3 certificate number.

• Proof of Exemption Seen/Not Seen: One of these must be selected if the patient has any exemption.

Universal Credit exemption

Legitimate claimants of Universal Credit exemption will have received an appropriate NHS award letter that confirms their entitlement to free NHS dental care.

At the time of treatment Providers ask claimants for a copy of the award letter, and then check the appropriate EXACT checkbox for either:

• No, although the patient is claiming universal credit exemption I have not seen evidence, or

• Yes, I have seen evidence.

  IMPORTANT: Providers must not presume exemption or advise patients that they are exempt.

Once Patient Gets Universal Credit is checked, it is not possible to continue without selecting one of the Proof of exemption buttons:

• Proof of exemption NOT seen

• Proof of exemption seen

If you try to continue without selecting a Proof option you will see an EXACT prompt Please enter proof of exemption as seen or unseen:

Whether the claimants provide letter proofs or not, Providers treat them as bona fide claimants.

Even with patients who are exempt, practices can still issue a custom charge:

Patient Pays/Does not Pay Section

The NHS regulations require a new section on a claim showing why in certain circumstances a patient paid, or did not pay for a service. This is done by checking the boxes in the following area of the ‘Exemptions and Charges’ window:

Where applicable, check the appropriate box when opening an NHS Course of Treatment.

The Exempt Symbol

If an Exemptions and Charges box is ticked the patient will be given an Exempt Symbol. This symbol is located right of the toolbar in the Patient file. It will be displayed the next time the patient’s file is opened.

The exempt symbol will remain in the patient’s file until all ticks are removed from the 'Exemptions & Charges' list in the FP17 form (at such time as the patient is no longer exempt).

Child Arrangements

If a patient is a child then the Exemptions and Charges dialog screen will appear, like the one below.
As children are automatically exempt they do not have the same options as adult patients. In this screen you will need to select whether or not you have seen proof of the child’s age. If they need to pay for their treatment you need to indicate why.

Regulation 11 Replacement Appliance / Ortho Appliance Options

If the patient needs to pay because they are receiving a "Regulation 11" replacement appliance, click the checkbox, and they will automatically be charged 56.70.

If two replacements are required, click the x2 checkbox, as shown above.

Similarly, if an ortho appliance is required, click the 'Ortho Appliance' field checkbox.

The total for the appliance(s) is displayed automatically and cannot be altered. Any additional charted items will be assigned a zero value.

For UDA contracts, this total value is displayed on the chart, TC dialog and paper forms. The UDA value is set to 12 whether or not the x2 box is ticked.

For Regulation 11 Ortho Appliances, the total amount is displayed on the chart and TC dialog only, as paper forms are not currently printed for ortho courses. UOA values are set to 0 whether or not the x2 box is ticked.

DMF (Decayed, Missing, Filled)

Applies to England and Isle of Man.

DMF was used successfully in the NHS Pilot program, and as a result the NHS now wants state of the mouth information on all NHS patients.

EXACT on-screen:

DMF scores are written to the FP17 Form:

When Providers attempt to send a claim, by default EXACT prompts them "Is the DMF score correct?"

Once practitioners habitually record DMF scores they may opt to dismiss this prompt, which can be re-enabled by Administrator-level users if necessary.

Deciduous and Adult

The DMF area on the capture form is differentiated into Deciduous and Adult, enabling capture of all Deciduous, all Adult, or a combination of Deciduous and Adult.

DMF scoring caters to Deciduous and Adult teeth, and a combination of the two.

DMF patients age 0-5:

Decayed teeth – deciduous 9323.

Missing teeth - deciduous 9324.

Filled teeth – deciduous 9325.

IMPORTANT: When base charting you need to mark all unerupted adult teeth as unerupted, otherwise you will see no deciduous scores in the DMF calculation.
For Missing deciduous teeth,
- "missing" means where a tooth has been extracted.
- exclude these from the count: ULA, ULB, URA, URB, LLA, LLB, LRA, LRB.

DMF patients age 6:

Decayed teeth – permanent 9320

Decayed teeth – deciduous 9323.

Missing teeth - deciduous 9324.

Filled teeth – deciduous 9325.

DMF patients age 7-11:

Decayed teeth – permanent 9320

Decayed teeth – deciduous 9323.

DMF patients age 12+

Decayed teeth – permanent 9320.

Missing teeth - permanent 9321.

Filled teeth – permanent 9322.

Additional Existing Caries service

An Existing Caries Base Chart service in the DMF category is included in the EXACT upgrade software.

Universal Credit Exemption

This applies to England, Wales and Scotland.

The purpose of this exemption is to allow the identification of patients entitled to the Universal credit exemption category, as the category moves from a piloting phase.

Legitimate claimants of Universal Credit exemption will have received an appropriate NHS award letter that confirms their entitlement to free NHS dental care.

At the time of treatment Providers ask claimants for a copy of the award letter, and then check the appropriate EXACT checkbox for either:

• No, although the patient is claiming universal credit exemption I have not seen evidence, or

• Yes, I have seen evidence.

(This has changed from the initial single checkbox, which defaulted to evidence seen if no action was taken by the dental practice when completing the paper form)

IMPORTANT: Providers must not presume exemption or advise patients that they are exempt.

Once the Patient Gets Universal Credit is checked, an attempt to continue without selecting one of the Proof buttons results in an EXACT prompt:

Even with patients who are exempt, practices can still issue a custom charge:

England and Wales:

IMPORTANT: Providers must not presume exemption or advise patients that they are exempt.

One of the following codes is transmitted to the NHS:

38 - The patient is entitled to universal credit

39 - The patient is entitled to universal credit but evidence of remission / exemption has not been provided

Scotland:

IMPORTANT: Providers must not presume exemption or advise patients that they are exempt.

Proof NOT seen / Seen is required, and one of the following codes is transmitted to the NHS:

37 - Universal Credit evidence has not been provided

38 - Universal credit evidence has been provided

Orthodontic Treatment

Orthodontic Courses of Treatment are charted in a similar way to non-orthodontic treatment, however a different option is selected on the exemptions and charges screen, and two claims must be submitted: an Orthodontic Assessment claim (at the beginning of the course), and an Orthodontic Completion claim (at the completion of all treatment).

IMPORTANT: If a patient is only assessed and reviewed, or assessed and treatment is refused, the practice will receive the UOA allotment for that work. If the patient is assessed and accepted for treatment, however, UOAs will not be awarded until the Orthodontic Commencement claim is received by the NHS Dental Services.

Enter and Complete and Orthodontic Assessment

1. Select the first Service item and start a new Course of Treatment.

2. In the ‘Exemptions and Charges’ screen, select ‘Ortho Assessment or Completion’ as shown below:

3. Conduct an assessment, for example a full case assessment as shown below:

   NOTE: The title bar of the course will show no UOAs at this time. The UOAs are not awarded until you have completed the course, and pressed the TC button. The number of UOA’s displayed on the FP17 will depend on the type of Assessment you select at this stage.

4. When the assessment is completed, click the ????? button, click the Ortho tab, and complete the appropriate details in that area of the FP17 form, similar to that shown below:

   NOTES:
   - An ‘Aesthetic Component’ is mandatory if '3' is selected as the value for the IOTN (Index of Orthodontic Treatment Need).
   - If the ‘Assess & Review’ option is selected, it will show 1 UOA for the assessment.
   - If the ‘Assess & Refuse Treatment’ option is selected, it will show 1 UOA, for the assessment.
   - If the ‘Assess & Accept for Treatment’ option is selected, the summary area of the form will show the maximum UOAs (as shown above), and the date that treatment began.

5. The Ortho Clinical Data tab shows the summary of treatment falling under the orthodontic data set categories, with the number of treatments listed to the left of each category. The information collated on this tab is stored in the database for later transmission to NHS Dental Services, printing on the FP17O form and for future reporting.

   EXACT fills in the information on the “Ortho Clinical Data” tab based on the Data Set categories assigned to the services for the TC'd COT. It will count only those services that have been ticked and charged as part of the course and determines what categories apply. The services are displayed on the tab as in the example below:

   A check will be made to ensure only Ortho Data Set categories are counted, excluding radiographs and extractions, and a warning will be displayed at TC time if conflicts occur.

6. The button allows you to correct the categories assigned to the services in the TC'd COT, if any of the categories are incorrect. When you click this button, it launches the “Update Clinical Data Set” window which will list all the services in the TC'd COT and the current Data Set categories assigned to them:

7. You can alter these categories by selecting the button or double-clicking on a service, which will launch a dialog displaying all the possible categories in a drop-down list.

   The button will save the changes made and return to the “Update Clinical Data Set” window with the change displayed.
   The button will return to the “Update Clinical Data Set” window without saving any changes.

8. Change the category and click on the “Update Clinical Data Set” window to update this record permanently so that if the service is ever charted in the future, the newly assigned category will apply. Any changes made will also be reflected in the current “Ortho Data Set” tab.

9. Click the FP17O tab to view and/or print the FP17O form:You can view the FP17O form by either clicking the button, or double-clicking the FP17O thumbnail. Either option displays the FP17O form so you an check the patient's data has been entered correctly.From the display you can view the other page of the form and print it if required.

   The button also allows you to print either the front, back, or both pages of the form.

   NOTE: As this is merely a view of the form (not “form emulation”), you cannot send the claim from the form itself, but must use the Send Claim button on the NHS FP17 window.

10. Once you are happy with the details displayed on the FP17O, click the

    button. The Claim will then be waiting for your next transmission and the patient will be invoiced for any necessary treatments.

If any mandatory patient or claim details are missing a message will appear asking you to enter this information. Once all the necessary information has been entered and saved your claim will then be processed.

Submit an Orthodontic Claim for Completion of Treatment

1. Create a new COT and continue to treat the patient as usual.

2. Tick each service/appointment as it is completed.

3. Click the ‘Charge’ button at the end of each visit.

4. When no further treatment is to be completed and you now wish to claim, click the

   button, select ‘Ortho Treatment’ as the claim type, and check the ‘Ortho Treatment Complete’ option on the NHS FP17 form as shown below:

5. Select the appropriate Treatment Abandoned, Discontinued or Completed option button as appropriate.

6. The IOTN calculated at the end of treatment must be sent. This is mandatory; if you fail to pick one, a message will appear directing you to do so. Matching the rules for assessment claims, the Aesthetic component score at the end of treatment is also required if the IOTN score is 3.

7. An IOTN score of 0 is valid (for transmission) in cases where the IOTN cannot be calculated (usually where the patient has transferred to the dentist part way through treatment.) The drop-down menu for both IOTN fields (assessment and completion) will show a blank score until you choose a value. If a zero score is selected, it will show “0 - score could not be calculated”.

8. Click the FP17O tab if you wish to view and/or print the completed FP17O form.

9. Click ‘Send Claim’, the Claim will await transmission to NHS Dental Services as normal.

Charting PDS Plus Services

The following codes were imported into your practice's Service list for April 2010:

These codes will automatically fall into your ‘Favourites’ category, so for easy access ensure this category is in the clinician’s service category list.

The PDS Plus services can be charted by adding them to a course of treatment when examining a patient, or you can use the options on the PDS Plus tab of the FP17 when you TC a course of treatment.

Tooth Decay Assessment

If one of your KPIs is 2.02 Tooth Decay Assessment you must base chart Active and Arrested Caries using the codes CP·CARACT and CP·CARARR or the data will not transmit to NHS Dental Services.

Basic Periodontal Exam (BPE)

If you have already carried out a BPE for the current COT, and it was logged no earlier than 1 week before the earliest treatment date for the COT, then you do not need to chart the BPE. The BPE score on the FP17 is defaulted from the most recent record. If there is no record from either source, all of the fields default to blank, which is decoded as - (i.e., 'no score').

To chart the BPE scores from the Chart tab, add the CP.BPE service to the current COT.

When you click the checkbox, the 'Care Pathways BPE' dialog is displayed:

Click in each field, and enter a score of 0,1,2,3, or 4 as appropriate. For 'no teeth', enter X. You can move between the boxes with the button on the keyboard.

Click the button when finished. The scores will then appear on the FP17 TC tab, where you can still alter them if necessary.

Visible Plaque

To chart the 'Visible Plaque' scores from the Chart tab, add the CP.PLQ or Visible Plaque service to the current COT.

When you click the checkbox, the 'Visible Plaque Chart' dialog is displayed:

You must enter data in the fields before you can TC the COT. Valid data is a score of 0,1,2,3 or an X for no teeth.

You can move between the boxes with the button on the keyboard.

As for BPE, the Visible Plaque can also be edited on the FP17, using the Visible Plaque drop-down options.

Soft Tissue Assessment

The service CP.STA is charted by adding it to the current COT, and ticking the checkbox to display the custom screen:

Choose an option from the drop-down: 'Nothing Abnormal', or 'Positive Finding'.

Tooth Brushing Instruction

If the patient is a new patient (that is, they haven't had an NHS course of treatment in the last two years), and has a CP·TBI service charted in the COT then the Tooth Brushing Advice option will be defaulted to Yes on the FP17.

Smokers

There are three services relating to smoking that can be charted: CP·TOB-NON for non-smokers, CP·TOB-REQST when a patient declines to divulge whether or not they are a smoker, and CP·TOB to enter the quantity smoked in a week. This latter service will pop up a custom window, as shown below, for you to enter the number smoked in a week:

Click in the 'Quantity' field and enter the quantity, or use the buttons to increment/decrement the number displayed.

A related service is the CP·SCA 'Smoking Cessation Advice', which is charted if you have given advice to a new patient about the benefits of stopping smoking .

Fluoride Varnish

Drag the CP·FLV service onto the current COT (or double-click it) to record that fluoride varnish has been applied.

PDS Plus

If you have not signed a PDS Plus contract, this will NOT affect you at all.
Otherwise, please refer to 'PDS Plus' for further details about configuration.

When PDS Plus has been set up, a new tab will be present on the FP17 TC dialog labelled 'PDS Plus' and will be the default tab displayed.

The PDS Plus assessment form on the FP17 is filled from charting carried out using the appropriate services during a patient examination.

Any missing information or changes can be completed simply by clicking on the drop-down buttons on the 'PDS Plus' tab on the FP17 TC screen and selecting the appropriate options:

This example shows all the available options, however your PDS Plus setup will most likely have some of these options 'greyed out' and unavailable, as you are able to choose which items apply to you. Similarly, any options not applicable to your patient will also be 'greyed out'.

Note too that some PDS Plus KPI data does not need to be recorded here as it is gathered through other avenues.

If you are running a PDS Plus contract alongside another non-PDS Plus contract in the practice, the performer is able to select which contract the COT applies to using the Performer and Contract Number fields in the top left of the screen.

To enter data

The PDS Plus assessment form is completed simply by accepting the defaults, or where they are not appropriate, clicking on the drop-down buttons and selecting another option. Details are as follows:

Incomplete Treatment

A claim can be placed for any treatment started even if a patient fails to return.

To Claim for Incomplete treatment:

For example: the patient did not return for a porcelain veneer fitting.

The Course of Treatment will be underway as follows:

1. Click on the button at the bottom of the chart tab to open the notes window, enter a Clinical Note explaining the reason treatment was not completed, and save the note, which will appear both in the Course of Treatment and on the claim:

   NOTE: Do not remove the original Porcelain Veneer Service. Keeping this in the COT is how EXACT can determine this has been an Incomplete COT.

2. Click the button to send the claim.

3. EXACT will warn that items in the Course of Treatment are not ticked as completed.

4. Click the ‘Yes’ button.

5. EXACT will automatically note the following on the FP17O form: The completion date MUST be entered. For incomplete courses, the last visit date is entered. (Note that entering 99/99/9999 is no longer valid).

6. After completing the FP17 form, clicking the button, and returning to the ‘Chart’ tab, the treatment that was not completed will have moved into the ‘Misc.’ tab.

7. If the patient returns in future, the outstanding treatment can then be moved into a new Course of Treatment.

   NOTE: Orthodontic treatment is always considered completed when claimed for; either as a completed assessment, or as a course of treatment that is completed by being abandoned, discontinued or finished.
   
   

Alerts

To assist Practices in complying with NHS regulations and obtaining the highest number of UDAs and UOAs for the treatment they provide; EXACT has a number of different alert symbols that appear in the Course of Treatment.

The Alerts are a warning only; if ignored, EXACT will not prevent the transmission of the claim.

Below is an example of a Course of Treatment with alerts:

As services are added to the Course of Treatment Alerts may appear to the left of the provider’s code. A service can have more than one alert, therefore view each alert separately.

To view an alert:

1. Double click on the alert symbol; a Rules window will appear explaining the alert.

2. Click the ‘OK’ button to close the Rules window.

Rectifying Charting Errors

On occasions mistakes may be made when charting NHS treatment. Once the service has been charged, it is then ‘locked’ and changes cannot be made without performing one of the processes described below. Whenever changes are made to a Course of Treatment, EXACT generates a record of the original treatment – it is never deleted, just ‘hidden’. The following chart will assist when choosing the process to use to rectify any mistakes:

Re-enabling Exemptions

This process will remove any invoices that have been created for NHS treatment prior to the treatment being TC’d. Once the invoices have been removed the treatment can be amended.

1. With the incorrect charged treatment on the screen, click on the ‘Exemptions’ button.

2. An additional button appears on the exemptions screen, which is only visible when treatment has been charged. This is the ‘Re-enable Exemptions’ button.

3. Click on the ‘Re-enable Exemptions’ button. The following screen will appear describing the process that is about to take place:

   Select ‘Yes’. This will re-display the treatment plan, showing all charges will have been reversed. Any incorrect treatment can now be un-ticked and amended.

Resubmitting Treatment

Once an NHS Course of Treatment has been TC’d you can not amend it without resubmitting the whole course.
Please read the instructions below on how to perform this task.

To resubmit treatment

1. Click on the button to open the ‘Patient Transactions’ screen, or the

   button to open the ‘Tooth History’ screen.

2. Highlight the Course of Treatment to amend.

3. Click on the button at the bottom of the screen. The following window will appear:

4. Select ‘Yes’ to return the Course of Treatment to the ‘Chart’ tab.

5. This will display the treatment plan in the condition it was in when it was originally TC’d.
   If you look in the patients transaction screen you will see that all the invoices have been reversed.
   You can now un-tick any treatment item within the Course of Treatment and amend the details or remove them. Once you amendments are complete you can TC the course again.

6. This will redisplay the treatment plan, showing that all charges will have been reversed. Any incorrect treatment can now be unticked, amended and TC’d.

   NOTE: If patient has made a payment for the treatment before you resubmitted it, then their account will show a credit. Don’t worry as this will be rectified once you TC the course again, depending on the amendments you have made. If the amendments you have made to the course mean that the patient has paid too much then you may need to reimburse them. If the course is more expensive then you may require the patient to make a further payment.

NHS Charting Validation

Interpreting Invalid Claim Entry Messages

The TC and Send Claim processes carry out validation checks. Not all Invalid Claim Entry messages imply details are incorrect.

Below is a partial list of possible errors and an explanation for each:

Mixing Non-Orthodontic & Orthodontic Treatment

Only Orthodontic treatment can be claimed for on an Orthodontic course. If non-ortho treatment is being claimed for at the same time, start a second Course of Treatment and keep orthodontic items in one Course of Treatment and items such as fillings in the other.

Mixing NHS & Private Treatment

A patient may undergo mixed Private and NHS treatment. In such cases it is necessary to split the treatment into two separate Courses of Treatment.

NOTE: It is mandatory to provide the patient with an NHS estimate in cases of mixed treatment.

Care must be taken to ensure that Services are selected correctly and placed into the appropriate Course of Treatment.

When the ‘History’, ‘TC’ and ‘Charge’ buttons are clicked, they could apply to any of the Courses of Treatment. To ensure charging or TC’ing the correct Course of Treatment, ensure that the tab for the particular Course of Treatment is selected. The selected tab is the one that will be charged.

To Chart NHS & Private Treatment:

1. Enter the NHS Treatment as normal.

2. Press the

   button located above the Current Course of Treatment window.

3. This will create a second Course of Treatment. If the patient normally undergoes NHS treatment the payor will show as 'NHS'.

4. Click into the Payor field and delete the text ‘NHS’, this field should now be blank, as shown below:

5. Click the ‘OK’ button to return to the ‘Chart’ tab.

6. The new Private COT will be displayed along with the NHS COT in the Current Course of Treatment Area.

7. Select the ‘Private Fees’ Category.

8. Chart the private treatment.

9. Double-click on the Course of Treatment to edit it, and select whether it is ‘Additional’ (treatment outside of NHS coverage) or ‘Alternative’ (enhanced treatment at the patient’s request, over and above what the NHS would have provide) as shown below:

10. Click on the

    button and generate an estimate of charges for the patient.

11. Once the estimate is accepted and the treatment provided, tick the services as completed (regardless of which Course of Treatment).

12. Charge or TC treatment when ready, ensuring that the Course of Treatment being charged is the selected tab.