NHS Dental Services

1. NHS Dental Services Darren BoelemaCustomer Liaison Manager

2. 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 OperationInformation ServicesMonitoring and Risk Management Services

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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 email accounts • Funding issues – what’s the incentive to spend £5 -20K?