We have been advised by our local health board, that when we refer out patients for minor oral surgery etc, we now need to claim for the banded treatment we have carried out, but take payment for the treatment that the patient will be receiving on referral - eg surgical extraction etc.
eg - if we have seen patient for exam and xray = Band 1 = £14.30 which we must claim, then referred the patient out for a surgical extraction = Band 2 = £46.00, which is the charge we must collect?!
But this will show as the patient being in credit - or do we override the charge in the claim screen?
We have been told to enter the band number in the Advanced Mandatory Services box - Box G in the Clinical Data Set. Telling us that this is on the FP17W form ?! - which is no longer used, as everyone has to send claims by EDI now.
I have looked at the CDS section on the patient claim screen, but cannot find the box ?!
Can you advise as to whether I am looking in the right place?
Inside the R4+ chart, add all the items the patient needs including the items that will be done on referral.
Then, in the treatment list at the bottom on the screen, right click the item to be done on referral and select "treatment on referral" you will then see the course charges for the full band of items, but only the UDAs for the items to be done at the practice are claimed. See the attached screen shot, you will see it is charging the full £62.10 for a band 2, but only claiming 1 UDA.
Hope that helps.
We have a lot of problems with these type of claims which are marked as failed to return. The claims get rejected by the BSA. I have spoken to Carestream about this for the last 2-3 years but it never gets resolved with any updates. When wil you sort this out as its not good tat the software will not send the claims correctly to the BSA. This is a very basic function that should not take this long to fix.