A warning - tax credits and claiming free nhs dental treatments

GlasweJen

For HC2 and HC3 we have to physically write the exemption certificate number on our GOS form, it's the only exemption where we can't cross "evidencenot produced".

METAL_MICKEY

duchesspink1 wrote: »

"the dentist has recommended that you see the hygienist and it is a private appointment, if you don't wish to book then i'll make a note and let the dentist know." we don't insist that anyone books anything they can't afford or don't agree to. we are offering a service and patients get to choose if they accept what is offered.

you're totally missing the point that its not the surgeries responsibility though, its up to the patient and really why on earth should the dental staff take any kind of responsiblity for ensuring patients claims are correct? Its up to the patient... end of. We are here to provide dental treatment, not a benefits enquiry service.

now to answer your tasks, i've been away for the weekend so forgive me for being slow in getting back to you.

I think we may be slightly at cross purposes. I actually agree with your theory of the surgery having zero responsibility. However, the only statement to support that is in the small print on the PR form which patients usually don't read. The contradiction and confusion lies in the more obvious advisory information in the public domain that patients and surgeries alike can see.

The NHSBSA advice says:

A client who is entitled to free NHS dental treatment shouldbe prepared to provide evidence in support of her/his claim. A dentist (or amember of her/his staff) is legally obliged to ask to see evidence and to makea record if satisfactory evidence is not supplied. The dentist will ask theclient to sign a form when s/he goes for treatment. If s/he does not have topay, s/he should put a cross in the appropriate box on the form.
1) Legally? What a nonsense as that is not monitored
2) In the context of that para it is clearly suggesting that the surgery does have a role in an assessment of what is seen and unintentionally the process suggests this to the patient. I have also seen copies of the guidance notes issued to surgeries and its rammed full of advice on how to spot valid evidence.

METAL_MICKEY

"the dentist has recommended that you see the hygienist andit is a private appointment, if you don't wish to book then i'll make a noteand let the dentist know." we don't insist that anyone books anything theycan't afford or don't agree to. we are offering a service and patients get tochoose if they accept what is offered"
Ooops i presume that was the answer to Q5
This scenario is of course down to the total mess made of the new contracts for which i have great sympathy for the dental profession. However, dentists are being a little naughty on this one and its the patients pocket that is getting hammered.
On the proviso that the patient does not have any serious perio issues and is not requesting treatment on cosmetic grounds, a basic Scale & Polish should be offered under the normal NHS treatment basis and NOT a private charge as is widely happening. The terms of the NHS contact with the PCT dictate that a dentist must provide the full range of NHS services as required to render a patient dentally fit. However, due to the economics of the poor dental contract way too many dentists are only now offering basic perio as part of a private service. Those dentists are technically in breach of the terms of service of their contract and any savvy patient would be entitled to complain to the PCT or PALS. Fortunately, for the surgeries most patients will not know this and they are focussed on getting their teeth sorted and of course they quite rightly don't want to fall out with their dentist who they may be happy with.

duchesspink1

METAL_MICKEY wrote: »

"the dentist has recommended that you see the hygienist andit is a private appointment, if you don't wish to book then i'll make a noteand let the dentist know." we don't insist that anyone books anything theycan't afford or don't agree to. we are offering a service and patients get tochoose if they accept what is offered"
Ooops i presume that was the answer to Q5
This scenario is of course down to the total mess made of the new contracts for which i have great sympathy for the dental profession. However, dentists are being a little naughty on this one and its the patients pocket that is getting hammered.
On the proviso that the patient does not have any serious perio issues and is not requesting treatment on cosmetic grounds, a basic Scale & Polish should be offered under the normal NHS treatment basis and NOT a private charge as is widely happening. The terms of the NHS contact with the PCT dictate that a dentist must provide the full range of NHS services as required to render a patient dentally fit. However, due to the economics of the poor dental contract way too many dentists are only now offering basic perio as part of a private service. Those dentists are technically in breach of the terms of service of their contract and any savvy patient would be entitled to complain to the PCT or PALS. Fortunately, for the surgeries most patients will not know this and they are focussed on getting their teeth sorted and of course they quite rightly don't want to fall out with their dentist who they may be happy with.

most dentists will provide a basic scale and polish under the nhs though, they can't send a patient to a hygienist with a private prescription if they are entitled to it under the nhs. The options must be offered so, dentist does check up and basic clean, advises the patient to come back in 3 months for another clean under nhs if necessary or offers them a private hygienist appointment which is far more than a basic scale and polish and usually takes upwards of 20 mins. When a dentist does the scale and polish, its a two min job at the end of an examination.
It isn't cost effective to have a hygienist in a practice doing nhs scale and polish treatments as the fee is way too low for the length of time taken to do it, minus the hygienists fee, nurse fee etc. The dentist would be in a loss situation.

METAL_MICKEY

OK duchesspink1 its time to mark your homework:D

On questions 1 to 4 you have actually given very sensible answers with which to detach yourselves from any responsibility in the process and we have noted the PR form small print confirms that that is OK. However, as highlighted earlier there still exists this paradox that the advice to surgeries is to ask to see valid evidence and there is loads of guidance as to what YOU should consider as valid. I like your standard response but just maybe for the patients sake surgeries should perhaps use a caveat phrase along the lines of "Please note that we are obliged to ask you to show us paperwork that YOU believe is evidence of a qualifying evidence".

Now lets look at why i asked those specific questions:

1) The biggest problem here surgery is that some surgery staff and particularly mant patients do not appreciate its not just being unemployed, but its the specific receipt of JSA and of the two types it must be Income Based. Whilst this is clearly indicated on the PR form the reality hat many patients bother to read the small print or are even afforded the chance to read it by busy front desk staff.

Another key issue is is that when asking for evidence very few patients will ever carry around or have easy access to their specific benefit entitlement letter. However, many patients will proffer and equally many surgeries ask to see their JSA signing on book. However, the flaws are that the dates on those books do not always confirm specific dates that JSA paid in relation to the course of treatment. And more importantly those books do not carry any confirmation as to what type of JSA is being paid. Now how difficult would it be for DWP to include that little detail!

2) The major problem here is that PR actually has no exemption category that remotely fits the war pension scenario. What usually occurs is that they will opt for ticking the Income Support box. In reality they should actually pay the charges and then retrospectively claim a refund using the HC5D form but only if there dental treatment was for their accepted disablement. Ergo its an expensive mistake when a veteran who loses a leg in in Iraq makes makes an incorrect claim anf gets asked to pay the NHS charges and a penalty charge of up to £100

3) Definitive DWP letters confirming which type of ESA is being paid are as rare as 'rocking horse manure'. And, unfottunately their standard ESA letter has a nightmare para that states that you are being paid "Conts and Income related ESA" in the exact same sentence but without confirming precsely which one is being paid. And DWP are in no hurry to address this problem

4) That's the correct answer, The biggest patient error is to just automatically assume that they are still entitled to the TCEC and there has just been a delay in the issue of the cards. However, in defence of patients neither the NHSBSA or HMRC bother to ever confirm that they are no longer entitled to the cards. And, losts of the benefit advice documentation incorrectly advises that if you don't have card yet you can just show you tax credit entitlement letter as evidence. This is leads to may penalty charges since patients just show their A4 WTC/CTC letters. The simplest solution here is to stop calling it a "certificate" when it is in fact a little NHS branded card.

Don't forget that you should still proceed with treatment regardless as to whether they show you evidence or not. As tempting as it may seem even in the scenario when you think they are deliberately making a fraufulent claim you cannot refuse treatment. In that instance you just explain that you will be marking the form as "evidence not seen" and that checks are made and recoveries made inc a penalty fine.

Heycock

My understanding is that WTC in itself is not a gateway to free health services UNLESS the WTC includes the disability element which you should get if the claimant or co-claimant is also getting higher rate DLA.

METAL_MICKEY

Heycock wrote: »

My understanding is that WTC in itself is not a gateway to free health services UNLESS the WTC includes the disability element which you should get if the claimant or co-claimant is also getting higher rate DLA.

If you go to the HMRC website there should be a flow chart you can follow to see if you meet the qualifying conditions. However, aside from working your way through that, if you have either WTC/CTC but you don't have a little white and blue branded card which is says "Tax Credit Exemption Certificate" then you are not entitled to claim free NHS dental treatmnent.

As i have mentioned previously in this post all the documentary advice on claiming should remove reference to the word "certificate" when the definitive proof of entitlement is a card. This simple error means that patients and surgeries alike will continue to mistakenly believe that any old A4 sheet that makes reference to WTC/CTC is proof of entitlement. The only time i have seen a relevant A4 sheet is when i have seen the actual NHSBSA cover letter which comes with the actual little white cards stuck to the front.

angecull31

What is the maximum wage you can earn before they cut you off from free dental work? We did qualify before but then my hubby got a pay rise and now we have to pay.

Thing is though that he has now changed jobs with a drop in pay and I just wondered if we would qualify again.

Thanks

METAL_MICKEY

angecull31 wrote: »

What is the maximum wage you can earn before they cut you off from free dental work? We did qualify before but then my hubby got a pay rise and now we have to pay.

Thing is though that he has now changed jobs with a drop in pay and I just wondered if we would qualify again.

Thanks

Which specific benefit did you receive previously that allowed you to claim free NHS dental treatment?

The bottom line is that if you now think that your income level has dropped enough, you will need to complete an HC1 form which is the application form for an HC2 Low Income Scheme Certificate. You can get an HC1 form from the Job Centre or some surgeries may carry stock.

Hope that helps