New Zealand Dental Benefits Scheme in D4Web

New Zealand Dental Benefits Scheme in D4Web

Quote
The New Zealand Dental Benefits Scheme - Preset features, Adding & Editing, Generating Approvals & Claims

Preset & Setup Features

OHSA & SDSA Items

OHSA & SDSA items are preset in D4Web Items page, there is nothing to do here.
  1. Click the navigation menu > Location Setup > Items page
  2. Oral Health Services > Sub categories:
    OHSA Items in D4Web end in O. Examples: FIL1O, DEN2O
  3. Special Dental Services > Sub categories:
    SDSA items in D4Web end in S. Examples: FIL1S, DEN2S

Linking OHSA & SDSA Items to Charting

The above items have been pre set to ensure the correct item codes are picked up for claiming
Those charting procedures (linked to relevant item codes) can be found in 2D Charting or 3D Charting.
  1. Click the navigation menu > Patients > 2D Charting or 3D Charting
    1. Operations menu > Oral Health Services > Select procedure
    2. Operations menu > Special Dental Services > Select procedure
Notes
Instructions for Charting steps are found below

Region List

The Region is preset however some editing is possible

  1. Click the navigation menu > Location Setup > System Tables page
  2. System Tables: Region List
    1. Remove the tick in Is Active box for Regions not applicable to the practice (optional)
    2. Click ADD to add more Regions

School List

The School List is preset however some editing is possible

  1. Click the navigation menu > Location Setup > System Tables page
  2. System Tables: School List
    1. Ignore or click DELETE any Schools not required (optional)
    2. Click ADD
       to add more Schools

Setup Agreement Holder (Provider) details for claiming

The Payee Number, Agreement Number and Provider ID are required, in order to process Dental Benefit Claims.

  1. Click the navigation menu > Management > Providers page
  2. Select the relevant Provider
  3. Tick OHSA/SDSA Agreement Holder box
    1. Enter the Payee No, Agreement No, Provider ID 1
    2. Click OK

Setup Patient File



Patients under NZ Dental Benefits should be setup per the below instructions to ensure amounts owing and paid are responsible by OHSA/SDSA.

  1. Click navigation menu > Patients > Patients page
  2. School: Select the School
  3. Address tab:
    1. Send Invoices to: Insurance, OHSA or SDSA

  4. Insurance / Various tab: 
    1. Fee Level: OHSA or SDSA
    2. NHI ID: Enter the ID

Working with NZ Dental Benefits

Charting for Patients on the DB Scheme

To ensure the correct items are used, when charting for a patient under either the Oral Health Service for Adolescents (OHSA) or Special Dental Service Agreement (SDSA) scheme, use the relevant menus in Charting pages. 
  1. Click the navigation menu > Patients > 2D Charting or 3D Charting
  2. Select the tooth/surface in Treatment Required
  3. Operations toolbar > Oral Health Services or Special Dental Services menus
    1. Select the required procedure

    2. The relevant item will be inserted directly into the Treatment Plan page 



InfoTo view Treatment Plan on the Charting page, turn on feature in Set Display Options

Generate a Prior Approval Form

Items requiring prior approval can be entered using the Charting (Treatment required), or by entering the items directly into Treatment Plan.
Only one request can be generated per Treatment Plan. A new Treatment Plan should be created if a prior approval request already exists for a plan.

  1. Click the navigation menu > Patients > Treatment Plan page
  2. Enter items if not already entered
  3. TreatPlan toolbar > Application for Prior Approval (NZ)
  4. If the patient does not have an NHI ID entered, enter it or select Create Claim without NHI Number
  5. Click OK

  6. Fill in the Application Form 
  7. Click Save
  8. Click Cancel to exit
Notes
Note: A copy of the application can be found in the Claims page

Approvals

Once a claim has been approved, the Approval Number must be added against the claim before proceeding. 

Entering Approval number

  1. Click the navigation menu > Patients > Claims page
  2. Enter the number in App No column for the relevant claim
  3. Once the Approval number is added to a Prior Approval claim, items in the claim will carry the Approval number when copied into Treatment

Completing Treatment

Once you have the approval and when the planned treatment has been completed, transfer the items done from Treatment Plan to Treatment.
  1. Click the navigation menu > Patients > Treatment page
  2. Click the red bulldozer icon 
    1. Highlight the completed items and click OK
  3. The completed item will now appear in the Treatment tab, ready for claiming

Generate OHSA Claim

  1. Click the navigation menu > Patients > Treatment page
  2. Enter items if not already entered. Or Click the red bulldozer icon if transferring from Treatment Plan
    1. Some items require the surface to be included to be approved.
  3. Itemised Invoices toolbar > Select New Invoice and Oral Health Services Claim > Individual Treat
  4. Highlight the item/s in the background and fill in the form as required
    1. Note: selectable items are in AQUA (Yellow when selected)
  5. Click PREVIEW to view, print and save the form or click SAVE

Generate OHSA Claim - High Caries Treatment Planning

  1. Click the navigation menu > Patients > Treatment page
  2. Enter items if not already entered. Or Click the red bulldozer icon if transferring from Treatment Plan
    1. Some items require the surface to be included to be approved.
  3. Itemised Invoices toolbar > Select New Invoice and Oral Health Services Claim > High Caries Treatment Planning
  4. Highlight the item/s in the background and fill in the form as required
    1. Note: selectable items are in AQUA (Yellow when selected)
  5. Click PREVIEW to view, print and save the form or click
    SAVE

Generate SDSA Claim

  1. Click the navigation menu > Patients > Treatment page
  2. Enter items if not already entered. Or Click the red bulldozer icon if transferring from Treatment Plan
    1. Some items require the surface to be included to be approved.
  3. Itemised Invoices toolbar > Select New Invoice and Special Dental Services Claim 
  4. Highlight the item/s in the background and fill in the form as required
    1. Note: selectable items are in AQUA (Yellow when selected)
  5. Review the "To be completed by agreement holder" section
    1. Tick applicable boxes (1 -5)
  6. Click PREVIEW to view, print and save the form or click SAVE

    • Related Articles

    • NZ Dental Benefits in Dental4Windows

      Charting patients under the NZ dental benefits scheme. Charting Patients under New Zealand (NZ) Dental Benefits Scheme To ensure the correct items are used, when charting for a patient under either the Oral Health Service for Adolescents (OHSA) or ...

    • Computerised Prescriptions (NZ) in Dental4Web

      Computerised Prescriptions generated directly from D4Web for New Zealand users Setup (NZ) Prescription Features Enter DC Registration Number Each Provider must have their NZ Dental Council Registration number entered in Providers page to use the ...

    • NZ Dental Benefits Generating Claims in D4W

      Generate NZ dental benefits SDS claim, SDSA claim, OHSA claim: high caried treatment planning, OHSA claim, OHSA claim: individual treatment and apply OHSA / SDS payments to claims. Generate New Zealand (NZ) Dental Benefits SDS Claim Go to Patient ...

    • Dental4Web 2025 New Features

      WHATS NEW NOW The following new and enhanced features are available in: Build: 25.723 DB5808 Limited release starts from: 29/7/2025 General release: TBC New Features and / or Modules No new features are available in this build Enhancements & ...

    • NZ Dental Benefits Approvals & Forms in D4W

      NZ dental benefit approval, generate a NZ dental benefits prior approval form and SDSA and OHSA claim summary forms. NZ Dental Benefit Approval Once a claim has been approved, the Approval Number must be added against the claim. Go to Patient Records ...