Mastering Your NHS Claims Report: Northern Ireland

The NHS Claims Report is your key to staying in control of your dental practice's financial health. You can use the filters within the report to keep track of your claims and prior approvals all in one place. Making for efficient claim management.

These NHS claims represent your practice revenue. Neglecting them can lead to lost income and administrative chaos. But, with Dentally's NHS Claims Report, you can streamline your administrative tasks and keep your finances in check.

In this blog, we will break down which filters you can use to find specific groups of patients to help you stay on top of your claims.  

Once you have navigated to your Dentally Reports menu and selected your NHS claims report, use the following status to find your desired claims.  

Status = Submitted,  Prior Approval Status = Not Required 
These claims have no PA on them and have been completed and sent to the board, we are now awaiting Received or Invalid returns from the NHS. 

Status = Received,  Prior Approval Status = Not Required 
These claims have no Prior Approval and have now been confirmed as received by the NHS. 

Status = Invalid,  Prior Approval Status = Not Required
There is an outstanding response on the claim, this must be dealt with and the claim re-sent to the NHS. 

Status = Error , Prior Approval Status = Not Required or Required 
The claim has yet to be sent as it has not passed Dentally validation for sending, check the claim for errors before resending (an example might be no valid treatment). 

Status = Completed, Prior Approval Status = Not Required or Approved 
These claims have come back on a schedule to be paid and the fees balanced.  

Status = Queried, Prior Approval Status = Not Required 
These claims have come back on a schedule, but the amounts differ from what was requested. These should be reviewed and then moved to Completed manually if happy. 

 Status = Submitted, Prior Approval Status = Required 
These claims have a Prior Approval requirement and we are now awaiting for a Received response so we know the NHS has received the Prior Approval for processing. 

Status = Received, Prior Approval Status = Required 
The Prior Approval claim has been received by the NHS and we are now awaiting approval. 

Status = Invalid, Prior Approval Status = Approved
These claims have now had a Prior Approval approved (there might be a response back with this Prior Approval to give a value for any “Fees as determined” codes). Now, the work can be completed, and the claim can be submitted once done. 

Status = Invalid, Prior Approval Status = Denied 
Your Prior Approval has not been approved by the NHS. 

Status = Submitted, Prior Approval Status = Approved
These claims have now had the full course of treatment completed and we have submitted the full claim and are awaiting a received response. 

Status = Received, Prior Approval Status = Approved 
The final claim has been received by the NHS and we are now awaiting payment. 

The detailed breakdown of claim statuses is your roadmap to successful claim management. In Dentally, these filters and statuses aren't just technicalities; they're tools to empower you and your practice. By utilising them effectively, you can ensure your NHS claims are in order and you're in control of your practice's financial well-being. Discover more over at our help centre. 

For any questions or further assistance, our support team is always available via Live Chat in Dentally to help you navigate the world of NHS claims management.