Thank you for your request for information which was initially received on 18 February 2024 about the following:

Hello under the freedom of information act 2000, please can you provide me with the following information: I am looking to seek a greater understanding into the processing of FP17 forms. Firstly please may you outline the process that occurs from when an FP17 is sent by a dentist to the NHSBSA, mentioning each individual check / department etc that the claim goes through (and why) before its approved or rejected. Also please mention any steps that may occur after the approval or rejection of a claim.

Secondly, for patients that are non residents of the UK from the EEA & Switzerland that have EHIC, does the NHS fund treatments performed on these patients? Does the NHS receive reimbursement from the relevant country? Also for countries that have bilateral agreements with the UK, is it normal for NHS to receive reimbursement for treatments performed on these non resident patients? Could you also please lay out the process taken in regards to claims made for these non resident patients, and how these claims are also monitored for fraud.

You clarified your request on 19 March 2024 and advised the following:

The information I’m looking for is in regards to the process that is taken by the dentists for these claims. Is it the same as any regular claim? May you please outline the process that the UK deals with these claims?

I am dealing with your request under the terms of the Freedom of Information Act 2000.

Response

FP17 Processing

Data relating to courses of NHS dental treatment is transmitted from individual Dental Practice Management Systems (DPMS) to the NHS Business Services Authority’s (NHSBSA) Compass system. A small percentage are input directly to Compass by the dental practice. Compass checks that the data received is in the correct format, that mandatory fields are present and that the correct combinations of fields are present. Data values are checked to confirm that they are valid, e.g. within expected ranges or from lists of acceptable values. If any errors are identified appropriate errors messages are returned to the relevant DPMS for the practice to correct and resubmit. If no errors are detected, the data is used to deduct the patient charges collected from the monthly contract payment and to record the Units of Activity against the total achieved by the contract. This is an automated process.

Funding of Dental treatment for non-residents of the UK

Visitors from some overseas territories and all crown dependencies are only eligible to receive necessary healthcare on the same basis as an ordinary resident during their temporary stay in the UK. This means that necessary healthcare received during this stay will only be free of charge, except where charges also apply to UK residents, such as for prescriptions or dental fees.

If a visitor attends a dental practice, it is down to the individual practice how they charge the patient. Any charges incurred are the responsibility of the visitor.

Further information can be found on the NHSBSA knowledge base website:

https://faq.nhsbsa.nhs.uk/knowledgebase/article/KA-04011/en-us

Details of the countries with reciprocal healthcare agreements and what treatment is available can be viewed via the following link: https://www.gov.uk/guidance/uk-reciprocal-healthcare-agreements-with-non-eu-countries

Reimbursement

If a patient attends A&E at a hospital with a dental complaint the cost will be claimed by the hospital using the Reporting Overseas Visitor Treatment (ROVT) portal where the patient has presented an EHIC or its Provisional Replacement Certificate (PRC) as well as the visitors treatment costs incurred. Information which is provided to us is the name of the patient, dates of entitlement from their EHIC or PRC, dates of treatment and the cost. No further details about what treatment, including type that was provided, are entered into the ROVT and therefore the NHSBSA is not able to provide information specific to NHS dental treatment.

Once treatment costs have been submitted via the ROVT from the NHS Trusts, the details are validated, is processed and sent to the relevant Member State for payment.

ROVT forms are processed by country by the NHSBSA Overseas Healthcare Services and reimbursement is then requested in batches from the relevant Member State via the Department of Health and Social Care (DHSC).

How claims are monitored for fraud

Information regarding fraud monitoring is not held by the NHSBSA as the NHSBSA does not have responsibility for checking whether dental patients are entitled to NHS services. However it is possible that NHS England and the DHSC may hold some or all of the information you require. They can be contacted at:

NHS England

PO Box 16738

Redditch

B97 9PT

Telephone 0300 311 22 33

Email: england.contactus@nhs.net

Department of Health and Social Care

Ministerial Correspondence and Public Enquiries Unit

Department of Health and Social Care

39 Victoria Street

London

SW1H 0EU

Contact form https://contactus.dhsc.gov.uk/

Data Queries

If you have any queries regarding the data provided, or if you plan on publishing the data please contact foirequests@nhsbsa.nhs.uk ensuring you quote the above reference. This is important to ensure that the figures are not misunderstood or misrepresented.

If you plan on producing a press or broadcast story based upon the data, please contact communicationsteam@nhsbsa.nhs.uk This is important to ensure that the figures are not misunderstood or misrepresented.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988 and is subject to NHSBSA copyright. This information is licenced under the terms of the Open Government Licence detailed at: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Should you wish to re-use the information you must include the following statement: “NHSBSA Copyright 2024” This information is licenced under the terms of the Open Government Licence:

http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

Failure to do so is a breach of the terms of the licence.

Information you receive which is not subject to NHSBSA Copyright continues to be protected by the copyright of the person, or organisation, from which the information originated. Please obtain their permission before reproducing any third party (non NHSBSA Copyright) information.