Dealing with Prior Approval Errors
There are 3 types of errors you may see when submitting a Prior Approval.
Dentally validation errors. These appear when you try and submit. They relate to specific fields on the claim that we have identified should be set up and we try to make sure that you don’t send information that will give you an error back straight away before the claim or Prior Approval is sent.
XML validation errors. As part of the process for sending a claim or Prior Approval the information is turned into a special document format called XML. Before Dentally sends this information it checks it has things like correct postcodes and field lengths. In this case the claim or Prior Approval has been saved, but not sent. You can usually work out what to do.For example, here is a message where the CHI number was too long: In this case you would delete the existing number, perform a new CHI search and resubmit the Prior Approval.
The Practitioner Services system doesn’t like the information. Resolving these can sometimes be quite involved.
Practitioner Services System Errors
You will typically see the following codes associated with your PA submissions returned by Practitioner Services from the Prior Approvals Report.
We have listed the code, and, in general terms, what to do about it. Individual details for each submission error can be found in the patient's record, under NHS Tab, Prior Approvals.
APP - The Prior Approval is Approved, now submit a Claim
RAI - Request for Additional Information - Provide Information using the 5 sections, or Upload attachments, whichever is needed.
ARE - Awaiting Receipt of Physical Evidence - Upload attachments. (Physical evidence should have been sent prior to request being submitted. This status indicates that P&CFS have received the request but are waiting for physical evidence to be received before reviewing the case – the dentist should not therefore be responding to a Prior Approval at this status)
RNR - Prior Approval Not Required - Submit a Claim not a Prior Approval
VAA - Validated Awaiting attachments - Provide Physical Evidence using Upload attachments
RVE - Returned due to Validation Errors - the errors are usually explained in the red or yellow bar at the top of the Prior Approval screen - Correct errors and Submit again.
REA - Returned as Evidence could not be Appended - Upload attachments and Submit again
RAC - Request for Approval Closed - in Messages, you will see the reason why this Prior Approval is closed
RAD - Request for Approval Declined.
For complex errors that you do not understand, or cannot work out how to resolve successfully, please contact the Dentally Support Team.
Other Dentally web pages to help you with Prior Approvals include: