DENTISTS practising in Scotland have been urged to pay close attention to the new GP17 form or risk missing out on payment due to late submission of claims.
The new form which was introduced in Scotland at the beginning of this month differs from the previous version in a number of respects.
Practitioner Services have set up road-shows, online teaching and a helpdesk in a coordinated effort to avoid any confusion but Doug Hamilton, dental adviser at MDDUS, suggests that there are certain provisions which merit additional consideration from a dento-legal perspective.
"Members should be particularly mindful of the new requirement to provide details regarding incomplete treatment," says Hamilton. "There are now two boxes, one which stipulates that the patient has failed to return and the other that the patient has withheld consent to further treatment.
"At first glance, it is difficult to identify the reason for this inclusion. It may have relevance where claim forms are opened and closed in quick succession, a pattern which tends to come under close scrutiny, particularly where circumvention of the prior approval limit is suspected.
"However, it is perhaps more likely that this information will be used to tighten up the recently activated three-month time bar."
This regulation provides that, where submission of a claim is delayed by more than three months, the form will be returned to the practitioner without payment.
"It is therefore important that the information in this section is accurate and corresponds with the entries in the clinical notes and the appointment book," says Hamilton. “Practitioners will also have noted the option to mark the claim as a free replacement. It should be emphasised that this does not represent a relaxation of last year’s decision to revoke this concession.
"In fact, free replacements can only be claimed in trauma cases. Furthermore, the definition of trauma for the purposes of making this claim is very restrictive. Therefore, practitioners should familiarise themselves with this part of the narrative in the guidance notes in order to avoid the risk of fee recovery in the future.”
Finally, Hamilton warns his colleagues to be particularly careful when charting their patients’ dentition.
"It is quite easy for treatment to be claimed on a lone standing molar or premolar which has previously been charted as missing," adds Hamilton. "However, since certain tooth specific items are now being recorded by Practitioner Services, such errors may lead to rejected forms or even enhanced monitoring. Practitioners should also note that surface-specific claims may still be scrutinised through targeted record card checks.
"Therefore, it is important to accurately record the surfaces which have been treated, together with the rationale for replacement of these restorations."
MDDUS members who wish further information in relation to this or any other dento-legal matters should not hesitate to contact an adviser.
This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.