NHS Dental Services Darren Boelema Customer Liaison Manager

NHS Dental Services Became part of NHS Business Services Authority in April 2006 with the 5 way merger of Dental, Prescriptions, Pensions, Logistics and Counter Fraud DS Core Services to Customers: Processing and Payment Operation Information Services Monitoring and Risk Management Services

Processing FP17 ‘Claims’ Process 40 million FP17s per annum 10,000 dental practices Make payments on behalf of Health Bodies in excess of £2 billion per annum Process 80+Million Unity of Dental Activity 85% submitted electronically

History of Transmitting Dentists Received dental claims electronically since 1990 Until 2004 claims submitted using Global Crossing (Racal) using X400 Store and Forward technology 2004 piloted use of Internet (WebEDI) From April 2008 all claims submitted using WebEDI Until 2006 there was a £900 grant for practices moving to electronic submission

Submission of Electronic Claims 1 Dentists register to use WebEDI with NHSDS Dentists provided with user id and password for connecting to Webservers Dentists provided with PIN For submission of claims, Dental System connects to WebEDI system and is authenticated Claims sent (128bit SSL ) encrypted to NHSDS Initial validation / Acknowledgement sent Invalid forms are returned with explanation Valid forms are accepted, then subjected to more rigorous validation inc. history checks

Submission of Electronic Claims 2 On a monthly basis payments calculated and any patient charges submitted on claims are deducted Monthly reconciliation report is sent to practice Regular reports provided to PCTs E Reporting (Business Objects) allows PCTs to interrogate contract data

Dental System Suppliers 15 certificated Dental System Suppliers NHSDS certificate the transmission module only Top 2 suppliers have 80% of the market Remaining suppliers vary from a few hundred practices to two Software suppliers are independent from NHS DS Little funding available to practices but some PCTs are proactive with incentives

Submission of Paper FP17s 15% paper FP17 Paper forms are scanned and keyed from image 48 hour turnaround from receipt to conversion to raw data file Higher error rate 2% compared to 0.1% for electronic submissions

Patient Signatures Patient signs PR form at practice Practice retains PR form and submits claim data electronically Regs require 2 year retention BDA advise practices to retain PR forms for 7 years Only submitted to NHSDS on request –eg. Benefit elegibility checks Dental Suppliers looking at capturing signature electronically using tablet technology

Issues Use of EDI not mandated although new policy initiatives require electronic submission NHS DS is too good at processing paper forms! Regulation changes / limited notice for DS and System Suppliers DS and DSSA work closely PIN security in practices/ Information Governance Difficulty communicating securely with dental practices/few NHS accounts Funding issues – what’s the incentive to spend £5 -20K?