Payment Verification - Adherence of Claim Coding

The request was partially successful.

Dear NHS National Services Scotland,

I am aware that Practitioner Services (PSD) / Counter Fraud Services (CFS) carry out Payment Verification (PV) exercises regularly in relation to primary care independent dental practitioners to verify adherence of claim coding to the narrative of the Scottish Dental Reference (SDR).

Can you please provide information in the year ending 2013 in relation to PV requests to independent dental practitioners with regards to:

1) What were the total number of PV requests issued to independent dental practitioners in year ending 2013?

2) Of the PV's issued, what number ( numerical or percentage ) were found to have demonstrated code mis-claiming that lead to financial correction or a further investigation.

3) Of those PV requests which showed mis-claiming / financial correction / further investigation, what was:
a) The highest amount to recover?
b) The lowest amount to recover?
c) The average amount in relation to all 'positive' PV requests?
d) The total sum of money identified for recovery during the period to year ending 2013?

Yours faithfully,

Donald Fisher

Communications (NHS NATIONAL SERVICES SCOTLAND),

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FOI (NHS NATIONAL SERVICES SCOTLAND),

1 Attachment

Dear Mr Fisher,

 

Freedom of Information Reference: FOI-2018-000329

 

I refer to your freedom of information request which we received on 20^th
September 2018, requesting the following information:

 

·         I am aware that Practitioner Services (PSD) / Counter Fraud
Services (CFS) carry out Payment Verification (PV) exercises regularly in
relation to primary care independent dental practitioners to verify
adherence of claim coding to the narrative of the Scottish Dental
Reference (SDR).

 

·         Can you please provide information in the year ending 2013 in
relation to PV requests to independent dental practitioners with regards
to:

 

1)    What were the total number of PV requests issued to independent
dental practitioners in year ending 2013?

 

2)    Of the PV's issued, what number ( numerical or percentage ) were
found to have demonstrated code mis-claiming  that lead to financial
correction or a further investigation.

 

3)    Of those PV requests which showed mis-claiming / financial
correction / further investigation, what was:

a)    The highest amount to recover?

b)    The lowest amount to recover?

c)    The average amount in relation to all 'positive' PV requests?

d)    The total sum of money identified for recovery during the period to
year ending 2013?

 

I confirm that under the terms of the Freedom of Information (Scotland)
Act 2002, a response to your information request will be sent within 20
working days of receipt, i.e. no later than 18^th October 2018.

 

Many thanks and kindest regards,

 

Roddy

 

 

Roddy Mitchell

Corporate Records & FOI Organisational Lead

Strategy & Governance Directorate

 

NHS National Services Scotland

Area 027

Gyle Square

1 South Gyle Crescent

Edinburgh, EH12 9EB

 

T: + 44 (0) 131 314 5604

 

[1][IMG]

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NHS National Services Scotland is the common name for the Common Services
Agency for the Scottish Health Service [2]www.nhsnss.org

 

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ROBERTSON, Tina (NHS NATIONAL SERVICES SCOTLAND),

1 Attachment

Dear Mr Fisher

 

Please find attached a letter seeking clarification before we can proceed
and respond to the above Freedom of Information (Scotland) Act 2002
request.

 

I will not be able to take this matter further without extra information
from you.   Until you make contact with me, we consider that this
information request is suspended and that the 20 working day response
timescale will not recommence.

 

Kind regards.

 

Tina

Tina Robertson
Information Governance Department
Practitioner & Counter Fraud Services

NHS National Services Scotland
Gyle Square
1 South Gyle Crescent
Edinburgh, EH12 9EB
T: 0131 275 6026
F: 0131 275 7195

[1]http://www.psd.scot.nhs.uk/professionals...

Please consider the environment before printing this email.

NHS National Services Scotland is the common name for the Common Services
Agency for the Scottish Health Service.  [2]www.nhsnss.org

 

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