Findings from DVA Compliance Review of Dental Services

In 2018, DVA conducted a comprehensive compliance review of dental services provided to clients, for the period 1 July 2014 to 30 June 2017.

DVA spends around $90 million each year on 678,000 dental services to clients, and the review showed the majority of dental providers are claiming correctly as per the DVA Notes for Allied Health Providers and the Dental Services Schedule of Fees.

However, the review did identify non-compliance by a minority of dentists and dental specialists, which mostly related to exceeding the Dental Schedule service limitations.

The top three areas of concern are:

• Incorrectly claiming kilometre travel allowance when a mobile provider.
• Exceeding client service limits for:
  • other preventative services (D141 oral hygiene instruction, D171 odontoplasty, D131 dietary analysis and advice); and
  • periodontic services (D/S221 analysis/recording and D222 debridement).

DVA will be writing to dental providers in early 2019 to provide education and/or seek financial recoveries where there has been non-compliant claiming.