Every NHS claim checked against clinical notes. Before the BSA checks them for you.
NHS dental claims are submitted on FP17 forms, and every claim carries a UDA value — 1 UDA for a Band 1 examination, 3 for Band 2 treatment, 12 for Band 3. The BSA audits claims and clinical notes for consistency. Inconsistencies trigger investigations, clawbacks, and in serious cases, fraud allegations. Most practices submit thousands of claims per year and nobody systematically checks that the treatment recorded matches the band claimed. Your UDA submission auditor reads clinical notes alongside the claim data and flags discrepancies before submission — a Band 2 claim where the notes only describe an examination, a Band 3 claim where the treatment hasn't been completed, a missing radiograph for a claimed extraction.
What Your Agent Actually Does
Your agent cross-references every NHS claim against clinical notes, flagging inconsistencies before they leave the building — protecting your contract and your clinicians.
Cross-references claims against clinical notes
For every FP17 submission, your agent checks that the claimed treatment band is consistent with what's recorded in the clinical notes. A Band 2 claim should show evidence of treatment delivered, not just an examination and treatment plan. A Band 3 claim should show the complex treatment was actually completed.
Flags common audit triggers
The BSA looks for patterns: high volumes of Band 2 claims, unusually high extraction rates, Band 3 claims without supporting radiographs, treatment completed in a single visit that typically requires multiple appointments. Your agent flags these patterns before they trigger an audit.
Checks exemption status accuracy
Patient claims free NHS treatment based on age, pregnancy, income support, or other qualifying criteria. Incorrect exemption claims lead to penalty charges and BSA investigations. Your agent validates exemption categories against patient demographics and known qualifying criteria.
Produces pre-submission audit reports
Before your batch goes to the BSA, your agent produces a summary: total claims, breakdown by band, flagged discrepancies, and recommended corrections. You fix the issues before submission, not after the BSA writes to you.
Maintains audit trail for BSA enquiries
If the BSA does query a claim, your agent provides a clear audit trail showing the claim was checked, what was verified, and when. Demonstrating a systematic checking process goes a long way in BSA investigations.
The real numbers.
| Practice manager time spot-checking claims | £1,000–£3,000/year |
| BSA clawback from inconsistent claims | £2,000–£20,000+ per incident |
| BSA investigation management time | £1,000–£3,000 per investigation |
| Realistic annual risk-adjusted cost | £3,000–£8,000 |
| Agent build (one-off, configured to your clinical system) | £3,000–£5,000 |
| Monthly running costs (hosting + AI usage) | £100–£200/month |
| BSA guidance and NHS regulation updates | Included in first year |
| Realistic first-year total | £4,200–£7,400 |
The BSA doesn't need to find fraud to cause you problems. An inconsistency between clinical notes and claim data — even an honest one — triggers a process that costs time, money, and stress. A pattern of inconsistencies triggers a formal investigation.
Most claims are accurate. But when you're submitting thousands per year across multiple clinicians, the occasional mismatch is inevitable. Your agent catches them before the BSA does.
Good fit / not a fit.
This works brilliantly for:
- Any NHS dental practice submitting FP17 claims — which is every NHS practice
- Practices with multiple associates submitting claims independently
- Practices that have previously been subject to BSA enquiry or investigation
- Practice owners who worry about claim consistency but don't have time to check every one
This probably isn't for you if:
- Your practice is entirely private with no NHS contract
- You have a dedicated claims administrator who manually audits every submission
- You submit very low volumes of NHS claims (fewer than 50 per month)
Let's talk.
We'll start with your claim volume, how many clinicians submit claims, and how your clinical notes are structured — Exact/SOE, Dentally, R4, or another system. Usually a 15-minute conversation.
hello@nimblecroft.com