NSW Oral Health Fee for Service Scheme - Private Practitioner Information

Last updated: 01 July 2008

What is the Oral Health Fee for Service Scheme?

The Oral Health Fee for Service Scheme (OHFFSS) is an alternative way of providing dental care by the Public Dental Service. This Scheme provides dental care through a private oral health practitioner. There are three types of dental care that can be provided: episodic and general dental care, plus dentures.

Who is considered a private oral health practitioner in the OHFFSS?

A The OHFFSS offers dentists and dental prosthetists the opportunity to register. Dental care can be provided by dental auxiliaries under the conditions identified in the Dental Practice Act 2001 Section 19 (3).

What is new in the OHFFSS?

The OHFFSS now includes treatment for children plus general dental care.

What are the fees associated with the OHFFSS in 2008?

To download the OHFFSS Schedule of fees Information Bulletin 2008_ 028 . The OHFFSS Schedule of Fees for 2008 is benchmarked to the 1 November 2007 Department of Veteran Affairs (DVA) Schedule of Fees.
Please note the OHFFSS Schedule of Fees also identifies the relevant Australian Dental Association (ADA) Schedule Eight item numbers that can be claimed for episodic and general treatment, and dentures.
ADA item numbers allocated for episodic and general dental care are at the DVA dentist rate whilst item numbers for dentures are at the DVA dental prosthetist rate.

How do I join the OHFFSS?

You will need to ring your local Public Dental Service (PDS) to ask for an Information Package that contains registration forms and relevant information regarding OHFFSS administration and clinical processes.

How do I register?

You will be asked to provide information regarding your professional registration, legal indemnity insurance and certificate of EPA equipment compliance certificate and EPA user licence. The PDS is required to carry out a criminal record and 'working with kids' check before ratifying your registration application.

How long does my procurement contract last?

Your procurement contract is valid for 5 years before it is reviewed.

How can I terminate my procurement contract if I wish to do so?

All you have to do is ring your local PDS and inform them of your wishes. It would be appreciated if you could give 2 weeks notice so administration is able to finalise any outstanding claims.

How is a public patient referred to a private oral health practitioner?

A public patient who has been given an OHFFSS voucher will be provided with a list of private oral health practitioners who have registered with the OHFFSS. Please note that your local PDS is unable to recommend one private oral health practitioner over another.

Who does the PDS provide dental care to?

All children who are younger than 18 years of age, and adults who are more than 18 years of age and are current holders of one of the following Centrelink concession cards:

• Health care card
• Pensioner Concession Card
• Commonwealth senior's card.
• Also anyone listed on their card

How do I know if a public patient has been approved to receive dental care under the OHFFSS?

A public patient will have a current OHFFSS voucher that will identify the type of dental care required. It is important to check the expiratory date on the voucher before commencing the dental care.

Q What is expected of the public patient who has been provided with an OHFFSS voucher?

The local PDS will inform the public patient that they need to:

• Ring a private oral health practitioner from the OHFFSS list within 10 days of receiving their OHFFSS voucher.
• Ring the private oral health practitioner to reschedule the appointment if they are unable to attend on the allocated date. They are also informed that they may be charged a fee by the private oral health practitioner if they do not attend the appointment without notification.
• Bring their current voucher, concession card and personal identification (such as drivers licence or Medicare card) to their first appointment
• Sign the OHFFSS voucher at the end of the dental care confirming they have received the dental treatment.

What is expected of a private oral health practitioner who is registered with the OHFFSS?

The PDS requires the support of the private oral health practitioner by:

• Checking the OHFFSS Voucher has not exceeded the expiry date.
• Checking the public patients' identity and their concession card is current.
• Reviewing and being satisfied with the medical history, medications, dental care identified on the OHFFSS Voucher and obtaining patient consent prior to the patient's dental treatment.
• Listing date and item numbers associated with the OHFFSS Voucher. NB only item numbers identified in the OHFFSS Schedule of Fees can be claimed.
• Obtaining the public patient's signature on the OHFFSS Voucher once the listed dental care is completed.
• Returning the OHFFSS Voucher to the PDS address provided on the voucher.

How do I know what type of dental care the public patient is to receive?

The OHFFSS Voucher that is given to a public patient will provide you with information regarding their presenting dental condition that requires dental care. An exception to this rule is if they have been given an OHFFSS Voucher over the phone as they would not have been seen by a public practitioner. If this is the case it should be indicated on the OHFFSS Voucher by the PDS.

What clinical support does the PDS provide a private oral health practitioner?

Each PDS has a designated contact person who will be able to help you with your clinical questions. Your local PDS will inform you of the designated contact person.
The questions that the designated contact person can help you with are?

• What should I do if the OHFFSS Voucher is out of date?
• What should if I do if I want to change the public patient's dental care identified on the OHFFSS Voucher?
• What should I do if the patient needs more dental care?
• What should I do if the patient requires an interpreter or Aboriginal Liaison Officer / Health Worker?

What claim support does the PDS provide a private oral health practitioner?

Each PDS has a designated contact person who will be able to help you with your claim questions. Your local PDS will inform you of the designated contact person.
The questions that the designated contact personnel can help you with are?

• What is the current payment status of my claims?
• What payment do I receive if the item number is associated with 'to be negotiated' (TBN)?

Who evaluates the OHFFSS?

NSW Health has established an OHFFSS Review Group that identifies areas of improvement for the Scheme and reviews the OHFFSS Schedule of Fees. The membership consists of representatives from NSW Health, PDS, non-government agencies, NSW Australian Dental Association, NSW Australian Dental Prosthetist Association Inc and NSW TAFE.

What are the PDS Call Centre contact numbers?

Ring the PDS Call Centre during normal business hours. The numbers are listed below:

Greater Southern Area Health Service
1300 789 404

Greater Western Area Health Service
1300 552 626 (Far West & Macquarie)
1300 552 208 (Mid West)

Hunter/New England Area Health Service
1300 651 625

North Coast Area Health Service
1300 651 625

Northern Sydney/Central Coast Area Health Service
1300 789 404

Southern Eastern Sydney/Illawarra Area Health Service
1300 369 651 (Illawarra)
1300 134 226 (South East Sydney)

Sydney South West Area Health Service
02 9293 3333 (Eastern region)
1300 559 393 (Western region)

Sydney West Area Health Service
1300 739 949
02 9845 6766