Listing NHS Responses

The List Responses window is used to view the messages received from NHS Dental Services and to initiate the resubmission of a Claim.

To open the List Responses window:

There are three places from where the List Responses window can be accessed:

• From the ‘Administration’ menu, select ‘NHS’ and then ‘List Responses’.

• By clicking on the ‘View Responses’ button on the ‘Transmission Summary’ screen once a transmission is completed, as shown below:

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• By clicking the NHS Responses button

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  in the UDA Manager screen.

Once any of these options is chosen, the List Responses window will display:

Column headings:

Options located across the bottom of this window:

Translation File

NHS Dental Services sends messages that contain response codes to practices. Rather than sending ‘Treatment has been approved’ for each accepted claim, a response code such as ‘A99’ represents that message. This reduces the amount of information exchanged during transmission and thus reduces the transmission time. EXACT has a Translation File that lists the actual text for each response code and matches this against the response codes received.

On occasion NHS Dental Services will update the response codes and send a new Translation File. This process should occur automatically during the transmission process. NHS Dental Services typically advises of the change in a broadcast response message.

Response Types

There are 4 broad categories of responses as shown below:

Interpreting Responses

Standard Response Messages

Claim Bundle Acknowledgement

NHS Dental Services will send confirmation for every claim bundle received successfully. These can be resolved with no further action required.

The List Claims window is used to ensure that all Claim Bundles transmitted have been received.

Broadcast Messages:

Messages from NHS Dental Services range from detailing upcoming changes to wishes for a Merry Christmas. These can be marked as ‘Resolved’ once read by the appropriate staff.

Claim Problems

If a claim has been rejected, the response message will explain the reason for rejection and quite often explain how to correct this.

NOTE: If the response message contains text in UPPERCASE this is often where a NHS Dental Services staff member has manually typed the response message. Further clarification of a Response can be given by contacting their helpdesk.

EDIFACT Format Error

If one of these messages is received it relates to missing information, e.g. missing patient details or no observations written when required.

NOTE: Where possible, EXACT generates an error message to prevent claiming if key information is missing. If a message similar to this is received, check the patient’s details screen. Look for: a missing title, a space before either the first or last name, or a space before the first line of the address. If any of these need amending do so and then retransmit. If the patient’s details appear complete but the transmission still fails due incomplete information, please contact Software of Excellence for further assistance.

Resubmitting Claims

Once treatment has been TC’d (Course of Treatment Completed) it is transferred into the Tooth History window and transactions created. When response messages are received detailing claim errors the COT needs to be copied back into the Current Course of Treatment area for correction, by selecting it and clicking on the

button, to reverse the original transactions.

The

button performs the following tasks:

• It voids the tooth history for the COT and copies the treatment back to the Current Course of Treatment Area.

• All Invoices for the Claim are to be reversed (credited) by way of an Adjustment. The Invoice and the Adjustment will display the resubmit symbol

  . This distinguishes the item from other Adjustments manually created by the practice.

QUICKTIP: For clarity when viewing items in a patient’s transactions window, turn off

so that only active items are displayed.

Resubmitting a COT from the List Responses Window

1. Highlight the response entry and click the Resubmit button. A dialog box will appear to confirm that the resubmission should occur, as shown below:

    

2. Click the ‘Yes’ button to continue.

3. From the ‘File’ menu or the Workspace Bar, click ‘Patients’. EXACT will automatically open the patient record for the highlighted patient in the ‘List Responses’ window.

4. Click the ‘Chart’ tab and make the necessary changes to the COT; e.g. add/remove services, alter FP17 Details, etc.

   NOTE: All Services that are ticked as completed will be given today’s date. After ticking a service as completed, alter the date (both the planned and completed) to the actual date of treatment. Failing to change the dates back to the true date of treatment may cause a further rejection when resubmitting the claim. To amend the date, tick the item as complete, double click on the date, and enter the date treatment was completed in the ‘Completion date’ field.

5. TC the Course of Treatment.

6. Verify that the FP17 details are correct.

7. Click ‘OK’ and the amended COT will be added to the Claims waiting for transmission.

   NOTE: The resubmission process can be repeated if the amended Claim does not satisfy NHS Dental Services. If the amendment has satisfied NHS Dental Services, no further responses will be received, not even to acknowledge the amended Claim is accepted. The claim will appear in the ‘Summary of Forms Processed’ section of a schedule.

8. If a COT is resubmitted more than once, then the auto text for observations may be added again. Before continuing, the duplicated text should be deleted.

1. Select the patient using the usual procedures.

2. Click on the

    

   sign for the patient, to display the transaction screen.

3. Highlight the Course of Treatment, and click on the Resubmit button.

4. A dialog box will appear to confirm that the resubmission should occur, as shown below:

    

5. Click the ‘Yes’ button to continue.

6. From the ‘File’ menu or the Workspace Bar, click ‘Patients’. EXACT will automatically open the patient record for the highlighted patient in the ‘List Responses’ window.

7. Click the ‘Chart’ tab and make the necessary changes to the COT; e.g. add/remove services, alter FP17 Details, etc.

   All Services that are ticked as completed will be given today’s date. After ticking a service as completed, alter the date (both the planned and completed) to the actual date of treatment. Failing to change the dates back to the true date of treatment may cause a further rejection when resubmitting the claim. To amend the date, tick the item as complete, double click on the date, and enter the date treatment was completed in the ‘Completion date’ field.

8. TC the Course of Treatment.

9. Verify that the FP17 details are correct.

10. Click ‘OK’ and the amended COT will be added to the Claims waiting for transmission.

    The resubmission process can be repeated if the amended Claim does not satisfy the NHS Dental Services. If the amendment has satisfied NHS Dental Services, no further responses will be received, not even to acknowledge the amended Claim is accepted. The claim will appear in the ‘Summary of Forms Processed’ section of a schedule.

11. If a COT is resubmitted more than once, then the autotext for observations may be added again. Before continuing, the duplicated text should be deleted.

    Treatment can also be resubmitted from any other screen where the

    button is active.