Certain restorations are guaranteed for 12 months including lost items from the completion date of the original one being fitted.
The restorations guaranteed are:
- fillings
- root fillings
- inlays or onlays
- porcelain veneers
- crowns
To be considered as guaranteed treatment, the treatment must be similar or related to the original restoration. It does not have to be like-for-like.
Items supplied under an urgent Course of Treatment (CoT) are also covered by the 12 month guarantee.
The guarantee does not apply if a completely different restoration is required.
If a restoration needs to be repaired or replaced during that time, there will not be a charge to the patient except where:
- a similar replacement restoration is not appropriate
- private treatment has been provided to the same tooth since the original restoration was provided
- the restoration was intended to be temporary
- the patient was advised a different type of restoration was more appropriate
- the replacement is required as a result of trauma
You'll receive the full UDA for the CoT provided.
If the CoT was originally carried out by a different clinician but the contract they were working on has now closed, any work carried out on the guaranteed item cannot be processed automatically under the new contract number as a 'Free repair replacement/guaranteed treatment'.
If you think this is unfair and wish for the work on the guaranteed item to be linked between the 2 contracts, you must speak with your Commissioner to see if they'll allow this.
If they agree, they can add an 'override rule' to Compass which will allow the claim to be resubmitted and accepted.