Update on eDental payment and prior approval modernisation project - April 2019

Our monthly update on the project to modernise payment and prior approvals as part of the eDental programme, covering:

  • eDental payment update – April 2019
  • ePrior Approval – Mandated from 1 October 2018
  • ePrior Approval supplier progress
  • eOrthodontic payment and approval – Mandated from 1 January 2020

eDental payment update – April 2019

eDental payments has now been live for around two years. If you require help, our eDental guidance offers advice and support.

ePrior Approval – Mandated from 1 October 2018

All re-approvals now require to be submitted electronically.  If the case was previously approved on paper, please provide all relevant supporting information.  When you receive a request for information, please add a scanned copy of the previously approved GP17-1 (both sides) in addition to any other relevant information.

Any prior approval request with an acceptance date prior to 1 October 2018 already started on paper and is as yet unapproved, may continue to be submitted on paper until 30 September 2019.

Practitioners should be aware:

  • A status of “Accepted” does not mean that the case has been approved. When a case is approved, you will receive an approval date and prior approval reference number along with an “Approved” status.
  • Some practices are getting confused with re-approvals and resubmissions, therefore ticking as a re-approval when not required. A re-approval can only be made where there is a change in treatment to an already approved case.  A resubmission is that which covers everything else.
  • When responding to a dental adviser request for more information with correspondence, please ensure the message response is added to the supplementary section.

If you receive the error ‘Electronic attachments could not be appended’, you have not ticked the box to indicate that you have uploaded digital attachments before you re-submitted the request.  In order to submit your request, you will need to upload one further image (this can be one you’ve already uploaded) and make sure you have indicated that attachments have been uploaded by ticking the relevant box, before attempting to re-submit.

Our prior approval guidance remains available, in addition to online videos and frequently asked questions.

If you are receiving error messages you do not understand, please review the guidance on the web site in the first instance.  If there are areas you feel would benefit from further guidance, contact our Customer Services team via email at nss.psddental@nhs.net  

ePrior Approval Supplier progress

Dentally, Software of Excellence (SOE EXACT), Systems for Dentists (SFD) and WYSdom practices all have the ability to submit prior approval claims electronically.  Goodteith and Software of Excellence (SOEL Health) are not offering a fully integrated system to system solution for prior approval; practices using these suppliers have been set up to use the web form, if they require it.

Computer Surgery and Carestream R4+ practices have also been set up to use the web form if it was something they requested.  In March 2019, Carestream carried out a pre fit for purpose (Ffp) testing ‘show and tell’ session.  This resulted in them moving to a formal fit for purpose testing session on 4 April 2019. 

As is expected during the Ffp process, there are some changes required which will require further testing before they can proceed to the next stage.  Once they pass this phase, they will be able to move on to the accreditation phase.  We do not currently have confirmed dates for this, although it is likely to be week commencing 23 April onwards.  We are aware that Carestream plan to rollout in early July 2019. 

Please see the PMS supplier page for up to date information on each supplier’s position.

eOrthodontic payment and approval – Mandated from 1 January 2020

From 1 January 2020, all new orthodontic prior approval requests and payments must be submitted electronically from your practice management system (PMS).  Paper submissions received beyond this date will not be accepted and will be returned.

An Orthodontic specialist event was held 15 April 2019, where the Scottish Government provided an update in terms of policy and the way forward, while Practitioner Services provided an update on the eDental programme and the plan for transition and rollout.  All PMS suppliers were invited to attend and provide an update on their plans.   

Updates were provided on the day by AssisOrtho, Carestream (R4+/Orthotrak), Dentally, Software of Excellence (SoE) and Systems for Dentists (SFD).  WYSdom had planned to attend, but due to unforeseen circumstances could not attend on the day.  A brief update was provided on their behalf by Practitioner Services.  Delivery dates were provided at the meeting, and as a result, we have updated our eOrthodontic PMS supplier page to reflect the current position.

It was agreed that a further meeting should be arranged around August 2019.

PMS Supplier testing will be undertaken in two parts.  Part one is fit for purpose (Ffp) testing, which tests the technical connections and communication channels between the PMS and ourselves.  The second part of supplier testing is accreditation and this takes place following a successful Ffp.  Accreditation is a verification process that allows us to test a set of valid business scenarios, which the PMS supplier must create as a dentist would, thus ensuring a level of satisfaction that their software will perform as expected.

Our table shows the current position of each supplier as at 16 April 2019. 

PMS Supplier

Current position

AssisOrtho

Committed and currently in development.  Several pre fit for purpose (Ffp) testing show and tell sessions have been carried out to date.  We are awaiting confirmation of timescales for formal fit for purpose testing from AssisOrtho.

Dentally

Committed to making changes, dates confirmed.  Fit for purpose anticipated in September 2019.

Software of Excellence (SoE) –Exact

Committed and currently in development.  Fit for purpose anticipated in June 2019.

Systems for Dentists (SFD)

Committed and currently in accreditation stage.

WYSdom

Committed to making changes, dates confirmed.  Fit for purpose anticipated at the end of October 2019.

Carestream

Committed and confirmed changes will be delivered in accordance with 1 January 2020 date.  Advised an update will be made available to practices by June 2019.

Orthotrac

Verbally committed in time with legislative date, but no confirmation of dates received.  Advised an update will be made available to practices by June 2019.

Computer Surgery

No confirmation received.

 

To understand the up to date position of each PMS supplier and detail around dates provided, view the eOrthodontic PMS supplier page.

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