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Guidelines for Payment and Prior Approval Claims

Guidelines for Payment and Prior Approval Claims

Prior Approval must be sought for all treatment claims where the cost will exceed £380.00.

Prior approval must also be sought for discretionary items listed in the latest SDR.

Please note that in cases where Prior Approval is required, only emergency treatment can be carried out before approval is granted.

Prior Approval must be sought immediately if a course of treatment will exceed the Prior Approval limit when additional work is required to be carried out.

To allow us to clinically assess cases submitted for Prior Approval we require relevant supporting documentation to be provided as soon as reasonably practical.

Prior Approval Modernisation

BSO FPS is working towards improving the Dental Prior Approval process and a major part of this work is around the FPPS Dental Payments Portal.  For this reason we are trying to establish how the Payments Portal is currently being used and what barriers are perhaps preventing Dentists from using it to submit their Prior Approvals.

 

Links to Documentation & Guides

  1. Guide to Prior Approval Claim Requirements
  2. Guide to Interim Orthodontic Payments
  3. Prior Approval Guidelines Poster
  4. Guidance for Prior Approval for 1 April 2014 onwards
  5. SDR letter 2014-15 from HSCB
  6. Prior Approval Flyer (Survey Sep/Oct-18)

Also in this Section

Also in this Section