Certain restorations are guaranteed for 12 months (including lost items) from the completion date of the original one being fitted. The restorations which are guaranteed are:
- Fillings
- Root fillings
- Inlays / Onlays
- Porcelain Veneers
- Crowns
To be considered as Guaranteed Treatment, the treatment required must be similar / related to the original restoration. However, it doesn't have to be like-for-like.
Example: A new filling is provided to replace the original filling that failed. However, the material used in the replacement filling can be different to the original if the performer considers there's clinical justification for using a different material e.g. the original filling was amalgam but the replacement filling is composite to improve retention of the filling or replacing a porcelain jacket crown with a porcelain bonded crown to increase the fracture resistance.
Items supplied under an Urgent Course of Treatment (CoT) are also covered by the 12 month guarantee.
The guarantee doesn't apply if a completely different restoration is now required.
If such a restoration needs to be repaired or replaced during that time there won't 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 that 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 performer but the contract they were working on has now closed then 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 feel this is unfair and wish for the work on the guaranteed item to be linked between the two contracts then you will need to speak with your Commissioner (Sustainability and Transformation Partnership / Local Health Board) to see if they'll allow this. If they agree to this, they are able to add an 'override rule' to Compass which will allow the claim to be resubmit and accepted.