NHS Treatment turned out to be private?!!!

wannabemedic

Hello

I've just received a letter from the dental services division regarding a refund of charges I asked for at my dental appointment - they say they can't refund my charges as it was private treatment

I had a back tooth chip when I ate some crusty bread and visited my regular dentist for remedial work - I didn't have an HC2 at the time (though I was entitled and this is confirmed) so I asked before my appointment for an NHS receipt as I knew I'd claim it back.

When in the chair the dentist said it would be £43.00 (which was a little odd as I'm sure the NHS charge was £43.50) so I confirmed with the dental assistant that I would get an NHS certificate - she went to check and confirmed I'd get a receipt.

Once treatment was over I was given a form saying 'private treatment' - I queried this but the idiot on reception seemed to have completely forgotten who I was and what she'd said to me earlier.

She said she couldn't give me an NHS receipt as 'it could only be issued at the time of payment' - despite the fact I reminded her at the time I was paying that I wanted an NHS receipt. :rolleyes:

They told me to send off the claim and ask the dental services people to contact them in case of problems - however now that they have been contacted, the practise have said it was private treatment and my claim has consequently been rejected. :mad:

The letter says I can go to the local PCT if I believe my treatment was provided under NHS arrangements...

I intend to write to the practise to ask for a refund because I remember they were told off by the PCT previously for hoodwinking patients onto private treatment so that they could sign up new NHS patients to the practise.

My priority is to get the £43.00 refunded, not to get the practise into any trouble but if that's a requisite for getting my money back then I'll have to do that.Thanks in advance

Toothsmith

Not quite sure what you're asking here wannabe?

It seems you are on top of the situation and are doing exactly the right thing.

There are probably are many NHS practices up and down the country who when doing simple treatments like single fillings just pocket the NHS patient charge, and don't bother with the paperwork necessary to claim their target points.

After all, if they do fill in the paperwork, then the £43.50 patient charge will be deducted off their monthly NHS cheque - so even more incentive not to declare it, especially if they are on target with their points total anyway.

It's similar to cases of pharmacists keeping NHS prescription fees when the tablets they're dispensing are cheaper than the £6.95 fee. Then binning the NHS prescription.

You are quite right to take it further with the PCT, and if the practice has been in trouble for such things before, there may well e consequences for them this time.

The bottom line though, is that they're defrauding the NHS.

wannabemedic

Thanks Toothsmith!

Sorry I wasn't clear - I'm asking them for my £43 back as they said I'd be given an NHS receipt to claim it back. However as the letter says the surgery said it was private my claim has been rejected - who's going to refund my money in this case?

alison999

It's £43.60 for a NHS filling anyway not £43.50.

Also, I work as a dental receptionist and if someone asked me BEFORE they went into surgery if they could have a NHS receipt I'd say yes too. But she probably didnt know what was going on in surgery at the time.

Maybe you should of questioned the fee at the time? The fee for a NHS filling is £43.60, you could right and ask for a refund, however that might mean that the dentist wouldnt get paid for the work and thats not really far. Also, now theres no such thing as registration, they might not see you again.

Id try to keep it friendly if I were you, I much more likely to do as much as i can for anice person then someone that shouts at me.

wannabemedic

alison999 wrote: »

It's £43.60 for a NHS filling anyway not £43.50.

Also, I work as a dental receptionist and if someone asked me BEFORE they went into surgery if they could have a NHS receipt I'd say yes too. But she probably didnt know what was going on in surgery at the time.

Maybe you should of questioned the fee at the time? The fee for a NHS filling is £43.60, you could right and ask for a refund, however that might mean that the dentist wouldnt get paid for the work and thats not really far. Also, now theres no such thing as registration, they might not see you again.

Id try to keep it friendly if I were you, I much more likely to do as much as i can for anice person then someone that shouts at me.

Firstly, she did know what was going on; she said I "could have an NHS receipt anyway". The part of your post about registration and not being seen again is slightly worrying - I hope this isn't the line my surgery tries to take as that would come across as a sort of blackmail, i.e. if you raise a complaint you won't be seen again.

There's a difference between raising a complaint and being friendly - I intend to remain polite (as I always do) whilst pointing out their shortfall and asking for my £43 to which I am entitled

donteatthat

I think the point here is that if the patient attended an NHS practice, and is entitled to NHS care, and was led to believe they were receiving NHS care and that they could claim their payment back via a HC2 form which they were entitled to receive.....then it would appear to me that some kind of - intentional or not - fraud may have been carried out by the practice. Never mind the dentist not getting paid for the treatment!! In the grand scheme of the usually horrendous overhead this will not be a huge amount of money to them I am sure. It is the dentist's responsibilty to ensure their staff understand the contract and know how to charge the patients appropriately. After 2 years the contracts small print should be understood I feel.

The PCTs', General Dental Council and DPB (or whatever they are called now) take a VERY DIM VIEW of this kind of thing, and I know of dentists who have been struck off for as little as £200 they have fraudulently taken from patients telling them they are having NHS care when in fact they have pocketed the money privately. This has nothing to do with the standard of the treatment - it is relating to whether or not the patients have been mislead.

If I was unlucky enough to still have to try to administer this daft new NHS contract I would ensure all my receptionists, nurses and other support staff knew how it all worked, to protect my backside against being struck off for this kind of error.

I hope you get your money back, and I wouldn't give 2 wallys about who foots the bill for it. You don't have to shout at the receptionist or be obnoxious about it as alison says they will be much more likely to try to sort out the error if you don't shout at them- the practice will have a complaints system in place, and if that doesn't resolve the issue then get on to the PCT.

HTH

donteatthat

Toothsmith

wannabemedic wrote: »

Thanks Toothsmith!

Sorry I wasn't clear - I'm asking them for my £43 back as they said I'd be given an NHS receipt to claim it back. However as the letter says the surgery said it was private my claim has been rejected - who's going to refund my money in this case?

Ok - got it now.

Step one is to go to the practice. Probably best to write a letter to 'The practice manager' or 'the senior partner' or even both!

State the facts as you have done in your 1st post.

• You attended for an NHS appointment
• You asked for an NHS receipt
• You paid what seemed to be an NHS fee
• No receipt was given
• At no point did you agree to be treated privately
• You now have an HC2 form and wish to claim back the NHS fee
• You cannot do this, because somewhere, someone has decided you paid privately.

Say that you are prepared to let them resolve this matter through their in-house complaints proceedure, but unless it results in you being refunded your money you will take the complaint forward to the PCT.

Tell them that if they possess any signed document from you which shows that you willingly and knowingly consented to private treatment, then you will gladly drop the complaint. (That is what they will need to prove you requested private treatment)

That should cover all the bases, and hopefully a refund cheque should drop through your door within a few days.

If you here nothing within a week, then telephone and tell them that you are taking your complaint directly to the PCT. You should then here the pop from their fingers being pulled out from 5 miles away!!!


BTW - if as a result of this, they decide to de-register you, then that is also worthy of a complaint to the PCT. So long as you remain polite and reasonable, a complaint like this is no grounds at all for de-registration.

wannabemedic

Thanks - letter is ready to go but I can't find a fax number on the NHS directory or on the online directory enquiry sites, so it'll need a call on monday to ask them for it

Thank you ever so much everyone who's replied on this thread, appreciate your help with this and I will update as things progress

domdent

Fax ?I think you will need to post it

Lorian

Recorded delivery/signed for too.

alison999

Lorian wrote: »

Recorded delivery/signed for too.

id use the special next day delivery, it'll get it sorted out much quicker ... what if before all this is sorted he fractures another tooth?? also, wannabemedic, did you sign a blue form when you went in? if you did, thats a nhs form you signed, for nhs treatment. another thing to bring up maybe?