Top tips for completing eDental claims - July 2018

To make the process of completing your claims as quick and easy as possible for your practice, we've put together some top tips to help you avoid common errors and to help improve your eDental claim turnaround.

Read our July update for the latest eDental news and updates

Commonly returned errors

We've put together a list of the most commonly returned errors - with information on how you can avoid them.

Error message

Reason

Additional information

E000852

For a claim type 2, the patient must be registered with a different list number at the same practice on the acceptance date.

A PMS may hold their own registration list, however, this may not always match what we hold in our payment system, Midas.  As patients are free to move between dentists and practices, we will always hold the most up to date record. We have highlighted this to a couple of PMS suppliers. 

The other reason, you may receive this error, is if our system cannot find a record for your patient, usually caused by the patient details on your system being slightly different to those held by Midas.

To resolve this, carry out a patient detail check, select the correct patient from the results and carry out a secondary search, then re-submit the claim.  If the claim fails for this error again after you have carried out the patient detail check, it is likely the patient is not registered with the dentist you think they are.   

If you select "none of the above" at the point of the search, you will be unable to use Claim Type 2 "I am registered with another dentist at this practice" because you have indicated the patient is new to the practice. 

E000631

An adult registration only claim is not allowed.

Treatment must be included on this claim, as only claims for children can be accepted without treatment.  It is possible you may have missed entering a fee code and/or completion date.

E000626

Your claim was not received within three months of the completion date.

We will only approve a case to override this rule under exceptional circumstances.  This must be agreed in advance, by emailing NSS.psd-customer-admin@nhs.net, detailing the number of claims you have and the reason they were not submitted within three months of completion. If we are satisfied that these claims should be paid, we will issue a unique reference number to be added to observations, so that we can undertake verification when the claims are submitted. 

E000603

The patient details response code has been used for a previous claim reference.

Carry out a new patient details check, using the list number of the dentist who is making the payment claim. If you still have issues, please contact your PMS supplier for further investigation.

E000673

As there is a completion date entered, enter the appropriate fee code(s), for the work carried out and being claimed.

If a Date of Completion is included on the claim, at least one treatment should appear on the claim.  If you appear to have a fee code and completion date completed, please contact your PMS supplier for further investigation.

E000614

Check the patient's Community Health Index (CHI) number as the first 6 digits must match the patient's date of birth.

The first 6 characters of the CHI number must match the patient’s date of birth, in ddmmyy format.  Confirm the patient's date of birth you hold is correct and if it does not match the CHI number in your PMS, remove the CHI number   and carry out a patient details check.

E000511

A previous valid submission for the claim is being progressed by the payment system.

An amended claim cannot be submitted if we have already processed it through to our payment system. You should follow the claim adjustment process once payment has been made and complete a Dental 283 form, if required.

E000681

Provide details of the tooth notation for all tooth specific items or if you are claiming for a capitation/continuing care code make sure the tooth notation is correct for that code. Retained deciduous teeth in adults should be coded as permanent teeth.

Ensure the tooth notation is correct for the tooth specific items specified on the claim.

E000509

The claim reference number has already been used for this list number and a case is either being processed or has already been paid.

You cannot re-use a reference number that has already been submitted. Confirm you have not previously submitted the claim. If you have not previously submitted the claim, contact your PMS supplier for further investigation. 

E000503

Check the list number as it is invalid.

The list number you have entered is incorrect; there is no dentist at your location with this list number.  Confirm you have entered the correct details.

E000710

A reason for referral must be provided for a referred patient.

Where the claim type is "I wish to be treated by this dentist as a referred patient", the reason for referral must be provided. Select from:

  • "Facilities"
  • "Experience"
  • "Expertise"

E000615

The ninth digit of the Community Health Index (CHI) number has to be odd for males and even for females.

The ninth character of the CHI number must be an odd number if the patient’s sex is Male and an even number if the sex is Female.  If the patient’s sex in your PMS is correct, remove the CHI number and carry out a patient detail search.

If you have a patient who has changed sex, a new CHI number is only allocated when the transition is complete.  You must continue to use the patient’s original details for claiming purposes until a new Chi number is allocated. To ensure the patient histories are linked up, you should submit a Dental 286 form advising  of previous name details.

E000623

Claim dates are not in the correct sequence. These dates must also be in sequence against the start and end dates of the list number.

The various claim dates (if supplied) must be in ascending order, as follows:

  • patient's date of birth
  • acceptance date
  • approval date
  • completion date
  • current date

For example, check that the completion date is after the acceptance date for example.

E000508

Check the Personal Identification Number (PIN), as the PIN supplied is invalid.

You have inaccurately entered the PIN number.  Check and try again. PIN’s are issued to individual dentists by NHSmail.  If you cannot locate the email, or have forgotten your PIN, contact the Dental Helpdesk.

E000622

If fee codes and amount claimed have been supplied, it is necessary to enter the acceptance date, completion date and approval date (if applicable).

The Date of Acceptance and Date of Completion must be entered if treatment details have been included on the claim. If the claim required prior approval, you must also include the approval date. If you do not know where to enter this on your system, contact your PMS supplier.

E000802

The value of treatment codes and the amount claimed are different. Verify the treatment carried out and the total claimed, as both the coded amount and amount claimed must be equal.

Check the value of treatment codes and the amount claimed, as they must be equal. Additional information is now provided to outline which code values are different.

E000677

Treatment code and quantity are not valid on the date of acceptance.

You are trying to claim a code that either does not exist, or did not exist in the SDR for the acceptance date you have on the claim. Check and amend as appropriate.

E000704

Item 17 treatment(s) have been claimed without a corresponding 1700 treatment also being claimed.

You have claimed treatment under Item 17 but not claimed the additional arch fee (1700).  Review the claim, and if treatment under Item 17 was carried out, add the applicable code to the claim and resubmit.

E000680

Invalid tooth identifiers have been specified.

The tooth notation provided is invalid for the fee code specified.  Certain items of treatment are only available for certain teeth, as indicated in the SDR.
Note: Retained deciduous teeth for adults should be recorded as permanent teeth.

E000669

Patient charge must be zero for the remission details specified.

Unless the patient has a remission of HC3 at completion then the patient charge must be £0.  

 

Read our eDental guidance for more on error codes.

Submitting eDental claims

A number of claims are still being unnecessarily rejected, often leading to a delay in processing and paying claims. 

These rejections mainly happen when practices provide observations that are not required.

Patient failed to return (PFTR): Only select the PFTR box in your PMS, unless you are requesting a fee not specified in the SDR.

Claim resubmissions: When a claim has been rejected, for example for being a duplicate, and returned as a paper MIDAS reply, resubmit only one and don’t add comments in observations.

Referral details: You do not need to enter the referring dentist details in observations, instead complete Claim Type 4 “on referral” and the reason for referral on your system/web form.

CHI number: You don’t need to let us know that no CHI has been found during the CHI search.

Domiciliary visit details: You don’t need to enter domiciliary details in observations.

Prior approval date: Enter the prior approval date in a specifically marked box on your PMS, do not add it as an observation.

Registration status: Observation are not required when the correct category for registration has been selected but additional observations have been added to indicate where the patient is registered.

Special needs (item 45c) details: Special need details are not required in observations.

Continuation case: Continuation details should be recorded in a separate area of your system, your PMS supplier guidance will offer more information.

Incomplete 10b: Where an incomplete 10b is being claimed, add the appropriate code to the claim without observations.

If you don’t know where to record something in your PMS, contact your supplier or check your PMS guidance.

Our eDental guidance has more information on observations.

Read more