Dept Veteran Affairs (DVA Online) Claiming for Dental4Web *PILOT MODE

Dept Veteran Affairs (DVA Online) Claiming for Dental4Web *PILOT MODE

Quote
Providers can claim items listed in the DVA schedule of fees — identified by a prefix before the item number (D: General Dentist, S: Specialist, T: Prosthodontist). Providers can also claim ADA items not included in the DVA schedule, provided prior approval has been obtained from DVA.
These setup instructions are intended for DVA Online users. 
Warning
*DVA Online with Dental4Web is currently in Pilot mode. General release coming soon

Pre Installation / Automatic Setup

Before Installation

Before contacting Centaur Software Support to setup DVA Online Claims, the surgery must be registered with PRODA.
InfoPlease visit the Services Australia website for additional information on this process: servicesaustralia.gov.au/proda

DVA Online Claiming rules / Prerequisites

As part of the DVA claim the following rules are applicable: 
  1. The Service Provider must contain a Payee Provider number 
  2. Maximum of 14 items can be processed per claim 
  3. Only one family member can be claimed at each time 
  4. Only one provider per claim
  5. The date of service must be the same for all items performed 
  6. All providers who intend to claim using DVA Online should ensure their provider ID is linked with the practice’s PRODA organisation.

DVA Online Automatic Setup

The following areas will be visible and configured automatically when DVA Online is setup by Centaur Support
 





Activate DVA Online: A new general setting has been created to allow information required for DVA claims to be stored in Dental4Web
Medicare Referral tab: Medicare Referral tab in the Patients page
Bank Assignments: The bank assignment redirection to be setup if the client creates bank slips and wishes to create a bank slip for the DVA Online payments.
Items: All DVA items (DVA General Dentist (D), DVA Specialist (S) and DVA Prosthodontist (T)) will be uploaded into Dental4Web
Methods of Payment: A payment method will be created for all DVA online payment/reconciliation
Discount Category: A discount category will be automatically created to apply on invoices not paid in full
Insurance: A new Insurance Fund called DVA Online will be available for online claims to allow Dental4Web to distinguish the DVA Insurances from other Insurances
Claims Reconciliation: A new page has been created to control all claims (submit, look at processed, unprocessed claims and generate reports on claims)
Recalls: The DVA Online item numbers will be added to the Items which execution date is shown in the column field
Fee Level/Fee Schedule: All fees provided by DVA have been uploaded into Dental4Web under the DVA Online Fee Level. Any increase or adjustment of fees after this upgrade is completed will need to be updated manually
2D/3D Charting: Three operations have been created in Charting for DVA Online Claiming (DVA General Dentist, DVA Specialist and DVA Prosthodontist)
Payee Provider: A Payee Provider is required to claim with DVA Online. This is usually the same as the Provider ID
 
Info
Support contact details
Phone: 02 9213 5000 extension 2

Device Configuration 

This section will help Dental4Web users complete the device activation process required for Dental4Web to access DVA online claims.
Before proceeding, ensure the Veteran Affairs (DVA) Online: Pre Installation / Automatic Setup steps have been completed

In your PRODA organisation

Dental4Web installations that will submit DVA transactions must be registered in PRODA and activated through Dental4Web:

  1. Navigate to B2B Devices

  2. Register a new B2B Device

  3. Enter a Device Name and Description

  4. Once the Device is registered. you’ll receive the following details:
    1. Device Activation Code
    2. Device Name
    3. PRODA RA
  5. These details are used to activate the Dental4Web installation to allow DVA Online claiming

In Dental4Web

  1. Click the navigation menu > DVA Claims page
  2. Operations menu > Activate PRODA Device

  3. Click ACTIVATE DEVICE to start the activation process

    1. For active devices, this window can be used to check the status of the device
    2. For new activations, complete the required fields in the Activate Device Window
      1. Organisation ID = PRODA RA
      2. Device Name
      3. Device Activation Code
  4. Click ACTIVATE DEVICE

    1. Your Device details will be confirmed
Alert
Important: 
The Dental4Web Device activation will expire on the Device Expiry Date.
To continue using Dental4Web to process claims, you will need to refresh its status on the PRODA portal.
Dental4Web will begin warning about the expiry at each start-up within 30 days of the Device Expiry.
If you receive this message, you should log into PRODA and Refresh the Device

Setup Dental4Web Features

Payee Provider

A Payee Provider is required to claim with DVA Online. This is usually the same as the Provider ID
  1. Click the navigation menu > Management > Providers page
  2. Payee Provider: Type the Provider ID

Manual Recall Triggers 

If recall triggers are used for recalls, the DVA items must be included in the trigger area

  1. Click the navigation menu > Debtors & Marketing > Mail Merge Setup page
  2. Select the recall reminder
    1. Items used to determine the last exam date: Add the relevant DVA items to show the last exam scale and clean for DVA patients on the Recalls page
    2. Recall Trigger Items: Add the DVA items to trigger a recall update. (Keep the existing ADA items)
  3. Repeat the steps for all other Recall Reminders 

Automated Recall Triggers

Do not change any other Recall Automation settings without consulting with support@centaursoftware.com.au
  1. Click the navigation menu > Location Management > Automation page > Recalls sub-tab 
  2. Select the recall reminder
    1. Items used to determine the last exam date: Add the relevant DVA items to show the last exam scale and clean for DVA patients on the Recalls page
    2. Recall Trigger Items: Add the DVA items to trigger a recall update. (Keep the existing ADA items)
  3. Repeat the steps for all other Automated Recall Reminders 
    Repeat the steps for all other Recall Reminders 

Patient Configuration

Main Responsible Party

  1. The Main Responsible Party can be changed when setting up the patient's record or when creating an invoice.
  2. Click the navigation menu > Patients > Patient Details page
  3. Address tab
  4. Send Invoices to = Insurance > DVA Online

Patient Fee Level

The patient's Fee Level to be set so the correct fees are charged.
  1. Click the navigation menu > Patients > Patient Details page
  2. Insurance/Various tab (see image below)
  3. Fee Level = DVA Online (See Fee Schedule topic below)

Patient Insurance Level

The DVA Insurance Fund and Plan needs to be assigned to the patient's record.
  1. Click the navigation menu > Patients > Patient Details page
  2. Insurance/Various tab
  3. Insurance Level = (DVA Online) VAA 
  4. Enter the patient DVA File number
  5. Date from
  6. Card Type: Select White or Gold from the drop list
  7. Condition: Only one condition can be selected. Conditions available are entered into the patient's history area  Applies to White Card only

Patient Referral

In some cases a referral source is required for DVA treatment.
  1. Click the navigation menu > Patients > Patient Details page
  2. Recalls/Referrals tab > Medicare
  3. Click the New Icon
  4. Select the Referring Provider from the Contacts list
  5. Once the new row is in the Medicare sub- tab, click into the Referral Date field to change if required
  6. Click into the Referral Period select the period
  7. Standard
  8. Indefinite
  9. Non-Standard = 6 Months is the default however it can be modified

Verifying Patient Details

Medicare has two ways of verifying if the patient is eligible as a DVA patient.
  1. Patient's name, middle name and surname, demographic details
  2. Patient's name, middle name and surname, demographic details and card number (PVV)
This allows the surgery to check the eligibility of the patient before commencement of a treatment and also it gives them the ability to update patient’s information based on data returned from Medicare.
  1. Click the navigation menu > Patient > Patients Details page
  2. Patient menu > Check DVA card details

Responses:
If there is a discrepancy between the Veteran details in Dental4Web and the details returned by DVA Online, a prompt with the differences will be displayed.
  1. Click UPDATE DETAILS to update Dental4Web

  2. If the check does not find a matching Veteran, this message is displayed

Download & Update DVA Fee Schedule

Each time the Department of Veterans Affairs implements a new Fee Schedule, the next Dental4Web upgrade will enable DVA Online users to download the changes.
Info
If update of fees are required before a D4Web upgrade becomes available, download the DVA schedule from the DVA website before proceeding with the steps below. 
  1. Click the navigation menu > Location Setup > Items page
  2. Record menu > Update 'DVA Item Schedule'
  3. Select the fee schedule to be updated

  4. Click CONTINUE
    Alert
    Once the above update has been completed, relevant items will be added/removed, and a new Fee Period with the new Fees will be added to the DVA Online Fee Level. 
  5. Next, click the navigation menu > Management > Fees page
    1. Select DVA Online fee level 
    2. Ensure the start date = start date of the new schedule (ie: 01/01/2026)
      1. If not, use the Modify Period icon to adjust the start date
    3. Scroll down to items starting with D or S and new fees are present
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Using DVA Online Features in Dental4Web

Charting, Treatment Plan & Treatment for DVA Online

Before proceeding, ensure all Setup steps have been completed: Pre installation, Pre-requisites & Setup,

Charting pages

Alert
If you use the standard menus and/or icons, the standard ADA items will appear on the Treatment Plan - resulting in claim being rejected.
When charting, use the menu Operations > DVA... so that the DVA items are automatically entered on the Treatment Plan.
  

Treatment Plan page

Items charted in the Treatment required are found in the treatment plan 

Treatment page

The items performed are processed from the Treatment tab to generate a DVA voucher for the patient to sign.
Once treatment items have been transferred from Treatment Plan or entered manually (if not treatment plan exists)
  1. Itemised Invoices menu > New Invoice Only

  2. Change the Main Responsible Party to: Insurance > DVA Online
  3. Tick Claim through Medicare Online to open the DVA Claim Details box

  4. The below fields will be auto populated in the DVA Claims Details window if the information was entered in Patient details page
    1. DOB: The patient's Date of Birth
    2. Card Number: The patient's DVA Card Number
    3. Card Type: Gold/White
    4. Conditions: The patient's medical conditions
    5. Referring Prv:  Referral Source

  5. The below will need to be entered by the surgery at the time of the claim if necessary
    1. Referral Override: Select from the drop list
    2. In Hospital: Select from the drop list
    3. Hospital Name: Enter the hospital name for the procedure
    4. Facility ID:  Enter Facility ID of the hospital
    5. Admission Date: Enter date
    6. Discharge Date Enter date
  6. Click OK to proceed or Notes: Click on the ‘yellow box’
    1. Distance KM: Select the distance
    2. Number of Teeth: Select the number of teeth
    3. Jaw: Select from the drop down list
    4. Time of Service: Enter the time
    5. Multiple Procedure Override: Select from the drop down lis
    6. Restrictive Override: Select from drop down
    7. Time Duration: Enter duration
    8. Duplicate Service Override: Select from the drop down list
    9. Self Deemed Code: Select from drop down
    10. Service Text: Enter the details of the service
    11. Click OK

  7. Click PRINT
    1. The Treatment Service Voucher printout must be on A4 paper.
    2. The item/s will turn purple to signify they have been included in a claim.

Claims page for DVA Online

Reprint Claims

The voucher can be reprinted from the Claims page.
Note: It’s recommended that after patient signs the voucher that this form is scanned into Document Manager.


Retrieve Claims

Medicare requires 24-48 hours to assess any online claim after being submitted All claims stay in the processing area until the claim has been processed by Medicare.
  1. Click the navigation menu >  Insurances > DVA Claims page
  2. Transaction: Processing
  3. Highlight the claim to be retrieved
  4. Click Retrieve to check if the claim has been processed.
    1. Status: Unprocessed/Error 2023
    2. Voucher: Voucher Number
    3. Rebate: Rebate Amount
    4. Exception: Exception Amount
When the claim is returned successfully the processed claim will be moved to the Payment area.

Payments for DVA Online

After all claims have been processed and accepted the payments need to be reconciled.
  1. Click the navigation menu >  Insurances > DVA Claims page
  2. Transaction: Payments
  3. Highlight the claim to be reconciled
  4. Click Reconcile to accept the voucher
When the claim has been reconciled the details are visible by clicking on the ‘Show deposited’ box
  1. A/C Name: Bank Account name
  2. BSB: BSB number
  3. A/C#: Account name
  4. Deposited: Total amount paid on the account
  5. Run Date: Date paid the amount
  6. Run Number: Reference number for this transaction
If the invoice wasn’t paid in full by Medicare the system will automatically create an adjustment discount.
Any discount created in Invoice tab will be created under DVA Online discount category.
  1. Click the navigation menu > Patients > Invoices page
If the payment received is more than the amount sent to DVA, D4W will adjust the total due on the invoice. A note will be created to identify the change.

DVA Online Reports

Reprint Processing Report

Any items that either failed assessment or where Medicare paid less than the charged amount.
  1. Click the navigation menu >  Insurances > DVA Claims page
    1. Operations toolbar > Reprint Processing Report

Reprint Payment Report

All claims that were processed in the payment run.
  1. Click the navigation menu >  Insurances > DVA Claims page
    1. Operations toolbar > Reprint Payment Report
DVA Online Trouble Shooting 

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