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Delivering on prior approvals

Scottish dental practitioners can be confident that they can undertake their NHS work effectively with Dentally.

In 2018, Dentally was delighted to be officially approved by the NHS Practitioner Services Divisions (PSD) e-Dental Programme Phase 2 reforms for NHS Scotland. 

For the Dentally team this marked the start of ongoing commitment in supporting Scottish practitioners, and we continue to invest in development and support in Scotland in order to make the process easy as possible for customers.

Our aim is for an error-free prior approvals and claims submission process, so that our dental practitioners get paid faster with a user interface within Dentally to manage the administration that is needed and reduce the burden.

How does it work?
  1. Signalling the need for a prior approval.

  2. Create and submit a prior approval request for validation.

  3. Upload any supporting evidence.

  4. Check your prior approval has been accepted.

  5. Track and monitor the status of your prior approvals.

  6. Submit your claims

  7. Reporting

If you have created a treatment plan and certain items on the plan require a prior approval or if the total cost of the treatment exceeds the practitioner’s prior approval limit, then a warning sign will appear to flag this up to you.

 

Prior Approval

Dentally lets you create and submit a prior approval request to be validated by Practitioner Services, in line with your prior approval limit. This validation ensures that all the information supplied is consistent.  As with all claims it will require you to have a CHI number or a search reference to proceed, it will also show any exemptions and allow you to add the required BPE as part of the process.

The next step is to go to the prior approval details and evidence screen within Dentally, and you can then work through all the fields to ensure everything is complete.  Once you are satisfied with your submission, you simply confirm the declaration and click submit.  At every stage of submission, if there are any errors, they will be flagged to you, such as incomplete or missing fields allowing you to check details and aim for an error-free submission.

If your request has been accepted, you will receive notification and a status code that tells you what you need to do next.   For example; it may be a code that means a request for further supporting evidence, and this can be done in Dentally from the Patient's record. Once it has been uploaded, you need to update the prior approval to inform Practitioner Services that this has been done. Once it is reviewed, the status at Practitioner Services will change to reflect this.

Dentally runs a request for updates daily, so you are always up to date. Over time, the status of the Prior Approval submission will change as the request is progressed, and as you submit information.  You will be notified within Dentally, whenever changes occur so you can closely track the status of your prior approvals without leaving the platform.

A useful tool at this stage is the Prior Approvals Report.  This enables you and your team to monitor the status of a prior approval submitted for a patient, so that appointments for treatments can be scheduled and arranged in the appointment book.

If you would like more information on the prior approvals requests and how Dentally can support you in managing this process, then please email us hello@dentally.co.  You may also find it useful to look at our detailed guides for NHS Scotland work with Dentally within our dedicated Support area here. 

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