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Different stages of an NHS claim

🏥 NHS EN/WA only - Learn about the different NHS claim statuses and Where you can monitor them from in Dentally

Amber Morris avatar
Written by Amber Morris
Updated this week

Stages of an NHS claim in England & Wales

For NHS England and Wales practices, once a course of NHS treatment has been completed, the clinician must submit the claim to receive their UDAs.

Claims are submitted in real time within Dentally, so no bundling and sending in bulk. The responsibility for submission however still remains with the clinician.


NHS claim lifecycle

NHS claims follow a structured sequence of statuses. Here's what each one means:

  • New - Recently created, it very quickly moves to queued.

  • Queued - The claim is waiting to be transmitted to the NHS. You’ll only see this status if there’s a problem with the physical sending of the claim. ⚠️ You do NOT need to manually submit these claims — transmission will happen automatically.

  • Received - The claim has been successfully sent to the NHS and is awaiting a response.

  • Submitted - The claim was successfully processed by the NHS system and is now pending reconciliation.

  • Completed - The claim has been paid and marked as complete.


Editing a claim after submission

Once a claim is submitted, you have one hour to edit and resubmit it (England and Wales only). Whilst the claim is still in the Queued status, it can be reopened, amended, and resubmitted. Fixing errors within this time ensures faster processing.

After the one-hour window, the claim will be submitted and the status will be changed to 'Received'. At this point you must wait for the NHS to respond before making changes.


For example: If you mistakenly submit a Band 3 treatment as Band 1, Once it reaches the 'Received'' status you’ll need to wait for the NHS to return the claim before correcting and resubmitting.


Other NHS claim statuses to watch

There are also a number of other NHS claim statuses which would indicate if there is a problem with the claim and if it needs attention.

Queried

The NHS has queried the claim, often due to a discrepancy in the amount claimed versus what they intend to pay.

  • Go to the individual patient record for guidance on what to do next. Queried claims often require a review of treatment details and possible adjustments to ensure accuracy before resubmission.

Error

There is a problem with the claim. Check the patient record for the error code and description to work out what you need to do next to resolve.

Invalid

The claim has been rejected and cannot be processed. Go to the individual patient record to see what is invalid and work out what you need to do next.

  • For example, an invalid FP17PR form will require generating a new one for the patient to sign before resubmitting. Invalid forms cannot be reused.


Handling specific scenarios

  • Early Submission

    For instance, in denture treatment claims submitted prematurely, additions or modifications can be made to the treatment plan if the claim remains open until the treatment concludes.

  • Deleting Claims

    Claims cannot be deleted; instead, erroneous claims should be withdrawn and corrected.

  • 'Unsubmitting' Claims
    Once a claim is submitted, it cannot be 'unsubmitted'. You must wait for NHS processing or invalidation before making further changes.


NHS Claims report

The NHS claims report shows all submitted claims and lets you filter by status to quickly identify claims that require immediate action, enabling better tracking and resolution of problems.

Filtering the report helps you stay on top of claims needing attention, speeding up resolution and improving claim success rates.

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