Dentist

· A. Eligibility and Registration

My clinic is already providing dental treatment under CHAS. Do I need to re-register my clinic to continue providing services under CHAS (Dental) when the scheme is extended to (Contd)

(Contd) cover more treatments and conditions?

Registration is a once-off process.

My clinic is not registered for CHAS. How do I register for it?

Please click here to register for CHAS

After you have registered for CHAS and the application has been approved, the assigned polyclinic administrator will follow-up directly with you to sign the CHAS contract.

Can I choose which polyclinic administrator I would like to sign the CHAS contract with?

Clinics are assigned by the system to a particular polyclinic administrator (e.g. NHGP or SHP) at the point of application in order to facilitate the administration of CHAS by the polyclinics from registration to claims processing.

· B. Services Provided

Who qualifies for treatment as a patient under CHAS?

Patients who hold a valid CHAS, Pioneer Generation (PG) or Public Assistance (PA) card are eligible to receive subsidies for medical/ dental treatment under CHAS. For patients with the Public Assistance (PA) card, there will not be any patient payable amount, and the cost of the bill will be reimbursed in full to the clinic.

From 1 November 2019, Merdeka Generation seniors will receive special CHAS subsidies at CHAS clinics. However, CHAS dental subsidies will not be applicable for CHAS Green cardholders.

How can I help my needy patients to apply for the CHAS card?

You can direct them to the nearest CDC, Community Centre/Club (CC), Polyclinic or Public Hospital to apply for the card. If you wish to keep some copies of the CHAS application form and brochures in your clinic to give to needy patients, please contact AIC at dental@chas.sg or 6632 1199 to request for the materials to be delivered to your clinic.

Alternatively, these can be downloaded here.

What types of dental treatment can be claimed under CHAS?

Under CHAS, you can claim subsidy from the Government for the provision of treatment for selected dental services. For the list of selected dental services covered under CHAS, please click here. Please login to MOH Healthcare Claims Portal (MHCP) for the detailed subsidy table.

· C. Patient Visit

Are both the patient and I still required to sign the CHAS Patient Consent Form (PCF)?

For visits on/after 1 January 2017, you and your patient no longer need to sign the PCF. This is because your patient will be deemed to have given their consent for your clinic to disclose their information with the Ministry of Health and its authorised agents, when they use the Health Assist or Pioneer Generation card at your clinic.

For your existing signed PCFs, please retain them for at least 6 years from the time they were signed, as per the 2015 National Guidelines for Retention Periods of Medical Records. Original paper records may be destroyed upon digitisation of medical records, as long as the copies are accurate and satisfy the legal requirements for admission as seconday evidence in court.

Is there a limit on the number of claims a CHAS patient can make?

Limits have been placed for certain dental services. Clinics are also not allowed to make more than one dental claim on the same day for the same patient. For more information, please refer to the detailed subsidy table on the MOH Healthcare Claims Portal (MHCP).

If I have patients who are being seen at the polyclinic for their dental conditions but wishes to seek treatment with my dental clinic under CHAS, (Contd)

(Contd) How can I access their previous medical records to continue their care?

Patients will need to obtain a memo from their previous polyclinic dentist. Alternatively, dental history can be obtained from the patients.

· D. Financial Matters

How much should I charge the patient?

Dentists have the autonomy to determine the reasonable rate to be charged to their patients. CHAS patients are expected to co-pay for their treatment under CHAS. However, for patients on the PA scheme, no fees should be collected directly – the full visit cost will be reimbursed by the Government. Clinics have 30 days from patient’s visit date to submit a claim.

Amount chargeable = Total bill - CHAS subsidy¹

¹Please refer to the dental subsidy schedule here (current till 31 Oct 2019) and here (from 1 November 2019) for more information on the CHAS dental subsidy.

Will there be a transaction cost deducted for submitting claims?

There will not be any additional transaction fees deducted from the subsidy amounts claimable for the visits.

I submitted a CHAS claim but it was rejected. What is the reason for this?

Claims may be rejected for various reasons (e.g. annual frequency limit for the patient has been met). Please contact your CHAS account manager to enquire on such claims.

When will the polyclinic reimburse my claim?

You will be reimbursed within 1 month from the receipt of your claim if there are no queries. If there are queries relating to your claim, payment will be made to you within 7 days after the resolution of all such queries.

The dentist can make 1 claim per patient per day. (Contd)

(Contd) What if the patient did scaling in the morning and came back in the evening for extraction? Can I claim for the second visit?

Dentists are only allowed one claim per patient per day.

Am I able to check if my patient is eligible to claim for procedures with yearly (e.g. scaling and polishing) (Cont'd)

(Cont'd) or 3-yearly limits (e.g. dentures)?

You will be able to check via the MOH Healthcare Claims Portal (MHCP) on the patient’s eligibility for each procedure. You will also be able to find out when the patient will be eligible for a next claim, if the patient has already exhausted the claim limits.

Are we required to issue itemised bill to all CHAS patients?

Itemised bills will help your patient better understand the charges for the services and medication received, and know how much CHAS subsidy the clinic is claiming for him/her.

From 1 January 2017, all CHAS clinics are required to issue an itemised bill to all CHAS (including PG and Public Assistance) patients. This includes patients whose charges are covered fully by CHAS subsidies and do not make any out-of-pocket payment. The itemised bill must at least state the following:

the total charges before CHAS subsidy (with a breakdown into Consultation, Medication, Investigation and Others);
the total CHAS subsidy given; and
the remaining amount that the patient pays.

Please note that if your clinic already issues bills that are more detailed, you do not need to make any changes to your bill format.

Minimun level of bill itemisation required:

Description	Quantity (Example)	Price (Before Subsidy) (Example)
Consultation
Extraction
Filling
Filling	x 2	$150.00
Removable Denture (Complete)
Removable Denture (Partial)
Denture Reline/Repair
Permanent Crown
Re-cementation
Root Canal Treatment
Incision and Drainage
Polishing	x 1	$30.00
Scaling	x 1	$40.00
Topical Fluoride
X-ray

Total Bill Before Subsidy (including GST, where applicable)		$220.00
-Total CHAS Subsidy		$187.50
= Amount You Pay		$32.50

You may contact your clinic’s AIC account manager to seek any clarification or help if needed.

· E. Referrals to Specialist Outpatient Clinics at National Dental Centre (NDC)

If I refer a CHAS patient to NDC or NUCOHS for treatment, will the patient be charged at a subsidised rate?

CHAS patients referred by a participating CHAS dentist will be considered a subsidised patient at NDC/National University Centre for Oral Health, Singapore (NUCOHS). However do note that this must be an unnamed referral. In addition, please complete the CHAS Referral Form for subsidised care at NDC/NUCOHS and attach it to your referral. When calling NDC/NUCOHS for an appointment, please inform NDC/NUCOHS of the patient’s CHAS status. Patients have to produce these documents, his CHAS / PA card and NRIC upon registration at NDC/NUCOHS.

Please note that referrals to NDC/NUCOHS is not applicable for CHAS Green cardholders.

Can I refer a CHAS patient directly for specialised tests at the NDC to be charged at subsidised rates?

The subsidised referral must be made to NDC and not directly to the laboratory, to ensure that the test ordered is necessary for the patient’s condition.

Can patients be referred to KTPH instead of NDC and NUHDC?

Dentists can only refer patients to NDC and NUHDC for subsidised treatment.

Can CHAS Green cardholder qualify for subsidised referrals to SOCs in public hospitals?

As both CHAS Green and MG cardholders are considered subsidised medical patients, CHAS Green and MG cardholders can also enjoy subsidised referrals to medical SOCs.

However, as CHAS Green cardholders do not receive dental subsidies, they would not qualify for subsidised referrals to dental SOCs.

· F. Audits

What aspects of compliance could I be audited on?

The polyclinic administrators may conduct operational and clinical audits on your clinic to check for compliance with the CHAS guidelines. The following table summarises the areas of compliance that may be audited:-

Type of audit	Aspects of Audit
Clinical	• Patient Consent Forms (PCFs) are required to be submitted for audit, for visits before 1 January 2017. For visits on/after 1 January 2017, clinic would no longer need to submit the PCFs for audit.
Financial	• Financial data was submitted for each visit for which a claim for Subsidy reimbursement under CHAS was made as required in the contract. • The CHAS Subsidy was used in accordance with specifications in the contract and such guidebook or guidelines that the Administrator or MOH may issue regarding CHAS.

What types of documents must I keep for audit purposes?

For the purposes of meeting the above audit requirements, dentists and the clinics are minimally required to keep the following set of documents:-

a) Patient Consent Forms are required to be submitted for audit, for visits before 1 January 2017. For visits on/after 1 January 2017, clinic would no longer need to submit the PCFs for audit.

b) Prescription or clinical notes detailing medication prescribed to the patient, if any;

c) Records of laboratory tests carried out for diagnosis and follow-up, if any; and

d) Records showing the itemised breakdown of the bills submitted for CHAS claims, including a record of the amount paid by the patient.

Who will conduct the audit?

Audits may be conducted by the polyclinic administrators or MOH appointed external auditors.

When will audits be conducted?

Audits will be scheduled by the auditors and may not occur during the same period for all participating dental clinics. A formal notice will be sent to your clinic informing you of an impending audit and sufficient notice will be given for you to collate the necessary documents for audit.

What will happen if discrepancies are found during an audit of my clinic?

In the event that discrepancies are found during the audit, the polyclinic administrators/MOH reserves the right to hire an independent party to conduct further investigations into the matter if need be. If non-compliance is determined, the polyclinics/MOH may issue a warning letter and/or terminate a clinic’s CHAS approved status as provided for in the CHAS contract.

If it is found that improper claims were made, dentists will be required to reimburse to the polyclinic any subsidy that was wrongfully received.

If you have a question on CHAS which is not covered in this FAQ, kindly contact AIC at gp@chas.sg or 6632 1199.