π‘ Top tip: Referral options must ONLY be selected at the start of a new NHS course of treatment, and should not be used when submitting claims for any subsequent claims.
How do NHS urgent referral claims work?
You will need to mark urgent patient referrals when charting, for patients referred urgently from the Health Boards or NHS 111.
Where a patient is detected to be a 'new' patient to the practice (ie. the patient has no previous NHS claims in the previous 3 years - not including urgent referral claims) and a treatment plan is started, the charting screen will give the option to mark the treatment plan as an urgent referral. This will ensure that an urgent referral Care Package is charted and charged appropriately from the beginning.
This will also mark the appropriate referral option on the NHS claim screen.
Where an incoming Urgent Referral patient is received, but the appointment is not attended, the claim fee is still claimable for this unattended visit. Where the plan is marked as New Patient Urgent Referral, the claim can be submitted without a treatment having been ticked as complete. This will automatically raise a claim for a non-attended urgent referral appointment.
π‘ Top tip: If the patient fails to attend, you do not need to chart the 'Patient failed to attend an urgent referral' treatment - simply use the toggle and this will be recognised by Dentally and by the NHS as an urgent referral.
How do NHS non-urgent referral claims work?
Where the incoming patient is being seen as a non-urgent DAP referral, this can be selected on the NHS claim screen and the appropriate marker will be sent on the claim:
Work is charted as normal and the appropriate care packages will be created.
Where Referral for Additional Services is appropriate (Domiciliary and Sedation) these should be charted on the treatment plan as normal. These treatments can be configured using NHS Treatment Categories 'Domiciliary Services' and 'Sedation Services'.
Where an external referral is required, this is selected on the NHS Claim screen using the appropriate tick option (both may apply).
Referral for Advanced Services - Advanced mandatory services are sedation, domiciliary care and orthodontics, which are provided under PDS arrangements.
Referral for High Needs - Where issues such as physical health needs or mental health prevent the totality of treatment required being provided, the patient would be expected to be subject to a High Needs Referral to the Community Dental Service.
π‘ Top tip: We recommend checking you have a suitable number of slots blocked out for this type of appointment. We recommend using zones to do this.