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