The NHS Centre in CareStack provides a centralised platform to manage all your NHS tasks, like claims, practice locations, and contracts. Let's explore how to use it to track claims and Units of Dental Activity (UDAs), manage your practice sites, and keep your contract records accurate for a smooth and compliant workflow.
Topics Covered
Access NHS Centre
To access the NHS Centre,
Navigate to the System Menu > select NHS Centre under Billing.
The NHS Centre has four tabs on the left.
- Claims
- NHS Tx Plans (Treatment Plans)
- Sites
- Contracts
Claims
Let's take a look at the Claims section. Here, you can track and manage all claims submitted to the NHS.
- You will find two tabs :
Dental Claims (UDA)
Under the Dental Claims,
- Filter and view claims using:
- Submitted On: Select a date range from the date picker.
- Contract: Choose the desired contracts from the dropdown.
- Location: Choose the desired location and click Apply.
- Clinician: All clinician names are listed here. (Non-NHS clinicians are labelled accordingly to avoid confusion if a clinician’s status changes between NHS and Non-NHS.)
Let's take a look at the KPIs displayed. Click on See Claims to view the corresponding claims in each category.
- Successful Confirmed UDAs: The total number of confirmed UDAs (Units of Dental Activity) confirmed regardless of claim status. This includes UDAs that were previously confirmed from claims that are currently in progress or have failed withdrawal.
- UDAs in Progress: The number of UDAs (Units of Dental Activity) associated with patient treatments that are currently underway that are Queued, Submitted, Queried and Received but not yet complete.
- Failed or Invalid Claims UDAs: The number of UDAs (Units of Dental Activity) for which a claim was submitted but rejected by the NHS.
- On Hold UDAs: The UDAs (Units of Dental Activity) for treatments where the claim process has been temporarily stopped.
- UDAs Remaining For the year: The number of UDAs (Units of Dental Activity) a practice still needs to deliver to meet its annual contractual target with the NHS. Hover over the tooltip to view the formula used.
In the Claims grid, you can view:
- NHS ID: You can search or view the Claim Reference Number used by the NHSBSA (NHS Business Services Authority) to uniquely identify the claim.
- Tx Plan (Treatment Plan): The treatment plan associated with the NHS claim.
- Patient Name: You can search or view the Patient's Name.
- Submitted On: The date the claim was last submitted to the NHSBSA.
- Start Date: Filter based on the Start Date.
- End Date: Filter based on the End Date.
- Clinician: The clinician who submitted the claim.
- Location: The location where the claim was submitted from.
- UDA Confirmed vs Claimed: The number before the slash represents the confirmed UDAs, while the number after indicates the scheduled UDAs agreed upon by NHSBSA.
- Patient Charge: The agreed patient charge.
- NHS Comment: You can search or view the messages received in regard to the claim from the NHSBSA's claims processing department.
- Claim Status: Indicates the claim status.
- The filters in the Claim Status are:
- Queued: The claim will be submitted soon.
- Submitted: The claim has reached the NHS.
- Failed: The claim contains errors and needs correction.
- Invalid: The claim was rejected by NHS.
- Received: The claim was accepted by NHS and is awaiting UDA mapping.
- Queried: The resubmitted claim has reached the NHS.
- Completed: The claim was approved by the NHS and UDAs have been mapped.
- On Hold: The claim is temporarily paused from moving forward.
- Cancelled: The claim was manually stopped from proceeding.
- Withdrawals: Withdrawals are in progress, or the withdrawal has failed or been withdrawn.
- You can either Select All items or choose the desired ones and then click Apply.
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Click the Status History icon to view a detailed status history for claims in the NHS Centre.
- The Claim Status History view shows how a claim progressed through each status, including the date and time of each change and the user who triggered it.
- Statuses are displayed in reverse chronological order.
You can select from any of the following Bulk Actions on the claims grid:
- Hold Claim
- Cancel Claim
- Push Back to Queue
Alternatively, you can use the three-dot menu next to the claim to Cancel Claim or Push Back to Queue.
You can navigate between claims using the angle brackets.
Ortho Claims (UOA)
Under the Ortho Claims,
- You can filter and view claims using the same KPIs as used in the Dental Claims (UDA).
- Below the KPIs you will find the Assessment Claims and Completion Claims tabs.
- Under Assessment Claims, you will find filters such as NHS ID, Tx Plan, Patient Name, Clinician, Location, Referral Date, UOA Confirmed vs Claimed, Submitted On, NHS Comment, and Claim Status.
- For all entries where completion claims have been submitted, you will find a link icon (
) next to their NHS ID which you can click to navigate to the respective completion claim.
- Under the Completion Claims, you will find filters such as NHS ID, Tx Plan, Patient Name, Provider, Location, Completion Date, Submitted On, NHS Comment and Claim Status.
Practices can use this simple guide to navigate to the NHS Centre and access claims within the system.