NHS Referral Claims
Referrals as part of an NHS Claim are two-part, one from the side of the practice who is referring the work elsewhere and one from the practice performing the work on referral.
There are two key items to understand regarding these:
The practice that initially sees the patient and refers them on needs to inform NHSBSA that they have referred this patient for work they could not do themselves. They also receive payment from the patient for the work, but they do not earn the UDAs.
The practice that carries out the work that has been referred to them, need to inform NHSBSA that this was work carried out on referral, and they receive the UDAs, but not the patient charge.
The practice referring the work elsewhere
This claim should include the work that the practice has carried out.
Let's use the model of a practice performing Band 1 work for a patient, but referring the patient elsewhere for some Band 2 work (for example a surgical extraction).
The Band 1 work is charted and completed as usual.
In addition, the practice should chart the 'Referral for Advanced Mandatory Services' treatment for the appropriate band. So for the surgical extraction - Band 2.
Note: These 'Referral for Advanced Mandatory Services' treatments are like any other NHS treatment in Dentally. They can be set up with any nomenclature or code, but they must have the correct NHS Treatment Category assigned.
In our example, the practice has charted an Exam (Band 1) and a referral for Band 2 services:
When the claim is submitted, the UDAs will be requested for the Bands 1 treatment, but the patient charge levied is for the Band 2 charge.
The practice carrying out the referred work
This practice sees the patient and carries out the work on referral. The patient does not pay the fees to this practice, but they earn the UDAs.
This practice just charts the work which has been completed as normal, the UDA band will be calculated, but the claim needs to be ticked as 'Treatment on Referral'
The claim is raised as Band 2, but with no patient charge
Ticking as Treatment on referral can be done in the Treatment plan Settings page at the base of the chart, OR when going through the claims submission pages:
