The Wales FP17 assurance pilot is a two year programme of reviews. We’re running this together with Welsh health boards to review FP17 claims.
The 6 monthly review exercises between April 2019 and March 2021 are:
- Rates of Band 3 inlay claims
- ACORN (Assessment of Clinical Oral Risks and Needs)
- Rates of FP17W claims per patient
Each review exercise will include 35 contracts. Providers will be asked to submit patient records for review. Where appropriate providers might need to complete a self-assessment of the claims submitted.
Our Provider Assurance Dental Activity Review (DAR) team will review the claims with our clinicians and let providers know the outcomes of the review. We'll then work collaboratively with providers to resolve any issues that have been found. Providers will have the opportunity to review and feedback on our findings.
Where inaccurate claiming is identified financial recovery and refunds of patient charges may be sought.