Occasionally, NHS claims may be returned with error messages or queries. Addressing these issues promptly ensures timely resolution and accurate reporting.
Why claims may be queried...
NHS claims are typically queried for two main reasons:
Late Submission: Claims submitted more than 2 months after the completion date are rejected.
Discrepancy in UDA Value: The UDAs awarded differ from what was requested.
Using the NHS Claims report
The NHS Claims Report is your primary tool for identifying and addressing queried claims. Practitioners can view their own claims, while users with permission levels 3 and 4 can view claims for all practitioners.
Steps to Identify Queried Claims:
Access the NHS Claims Report from Reports > Treatment > NHS Claims.
Set filters to:
Relevant date range.
Status as Queried.
Review the Comments section for NHSBSA responses explaining the issue. These comments are also visible in the patient’s record under NHS > Claims.
Resolving common query issues
Late Submitted Claims
Issue: Claims sent more than 2 months after the completion date are rejected by NHSBSA.
Solution:
Incorrect Completion Date:
Open the treatment plan associated with the claim.
Resubmit the claim, correcting the completion date during submission.
Genuinely Late Claim:
Mark the claim as "Complete" to settle it and remove it from the Queried status.
This claim will not record UDAs in your NHS UDA report but will appear in the Completed status in the NHS Claims Report.
How to Mark a Claim as Complete:
Open the patient’s record.
Go to the NHS Claims tab.
Use the dropdown by the claim’s state to select Complete.
UDA Value Discrepancy
Issue: NHSBSA awards fewer UDAs than requested.
Solution:
Resolve the Issue: Contact NHSBSA to understand and rectify the discrepancy. Adjust and resubmit the claim if necessary.
Accept the Awarded UDAs:
Open the patient’s record.
Go to the NHS Claims tab.
Use the dropdown by the claim’s state to select Complete.
The claim will now reflect the awarded UDAs in the NHS UDA Forecast Report.
If your query is not mentioned above and you need advice on a different query please reach out to our team via support chat.
Tips for managing your NHS claims
Monitor Regularly: Check the NHS Claims Report and notifications to stay updated on the status of queried claims.
Use the UDA Forecast Report: This report warns you when claims are approaching the 2-month submission deadline, helping you prioritise actions.
Incomplete Treatment Plans: You can submit claims for incomplete treatment outside the 2-month window if the patient fails to return. However, it is best practice to submit these within 2 months of the last completed work.
By proactively managing queries and using the NHS Claims and UDA Forecast reports effectively, you can ensure accurate submissions and minimise financial loss.
For additional support, refer to our article on submitting incomplete claims or reach out to our team via Support Chat.