Update on eDental payment and prior approval modernisation project – December 2018

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

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

eDental payment update – December 2018

If your Practice Management System (PMS) supplier has made a new version of software available, we recommend updating to this. This will ensure you have the latest fixes in place. 

If you have any queries specifically in relation to error codes or payments, refer to our eDental guidance.

ePrior Approval – Mandated from 1 October 2018

From 1 October 2018 all new prior approval requests must be submitted electronically, either from your practice management system or through the web form.  Paper submissions will not be accepted, and will be returned to you.

Two exceptions for paper submissions will be allowed until 31 March 2019.

  1. If the case was submitted and approved on paper prior to 1 October 2018, then requires re-approval, we will accept this re-submission on the existing paper GP17 form.
  2. A prior approval request submitted on paper prior to 1 October 2018, but was not approved and was returned to you for clarification.

In November 2018, in addition to the prior approval guidance already available, we added some online videos to help practices understand the process for creating and submitting an electronic Prior Approval submission. 

Take a closer look at our prior approval guidance and videos.

Our clinical team have noted some incorrectly completed electronic submissions from dentists using the web form for the purposes of Prior Approval.

Ways to avoid unnecessary returns include:

  • When using the web form, ticking the box beside any of the treatments listed at the top of the ‘Other Treatment’ tab adds it to your treatment plan. You do not need to enter it again using the treatment code.
  • The entries for ‘Upper denture’ and ‘Lower denture’ relate to full upper and full lower dentures and should not be selected if you are adding a partial denture to your treatment plan. Partial dentures should be added on the ‘Tooth Specific Treatment’ tab.
  • Entering a number in the box for ‘No of Small Radiographs’ or ‘No of Colour Photographs 3(A)’ also adds these to the treatment plan.
  • Before you submit the request, always update the table on the ‘Value Summary’ tab, by clicking the ‘Get SDR Values and Refresh Table’ button. Review the table on the ‘Value Summary’ tab to make sure there are no duplicate items and the value shown is correct.
  • If you need to go back and amend any treatment, remember to update the table on the ‘Value Summary’ tab again before you submit.

Our Customer Services team is working on producing a frequently asked questions guide for ePrior Approval. We hope to make this available before the end of the year.

ePrior Approval Supplier progress

We have provided an update on the current position of each PMS supplier, but you should check the PMS supplier page for the most up to date information. 

Carestream

Carestream have confirmed they intend to provide an integrated system to system solution for electronic prior approval.  We are awaiting timescales about this will be developed, tested and available for fit for purpose testing and ultimately, accreditation and rollout. 

As an interim solution, Carestream practices must use the web form to submit their Prior Approvals electronically from 1 October 2018, until such time as their development has been successfully accredited and rolled out to customers. 

We have set up access for all dentists in practices who have submitted the online form.  These account for the majority of Carestream practices, with approximately 5% remaining who have yet to request a username and password.

Practices must complete the online form in order to submit Prior Approvals electronically using the web form. 

You must provide valid NHS.net email addresses as part of this process, and confirm they have not expired.  If you do not have usernames and passwords for accessing the web form, you must ensure you action this now.

Once we have sent your username and password to you, Carestream will issue your practice with a new software release, which you will need to install.  There is a dependency on your practice completing the online form and allowing sufficient time for these subsequent actions to take place. 

Dentally

Live rollout fully completed.

Goodteith

Goodteith have confirmed they will not be offering a fully integrated system to system solution for prior approval. 

We have set up requests for all practices who have submitted the online form to us - there are approximately 9% remaining who have yet to request a username and password.

Practices must complete the online form in order to submit Prior Approvals electronically using the web form. 

You must provide valid NHS.net email addresses as part of this process, and confirm they have not expired.  If you do not have usernames and passwords for accessing the web form, you should action this now.

Software of Excellence (SoE)

EXACT

SoE have completed ePrior Approval accreditation and made their software available for practices. The majority of practices are now set up to submit electronic prior approvals.  Although SoE have been in touch with the remaining practices, approximately 14% are still to register for SoE Connect in order to be able to submit electronic prior approvals. If this applies to your practice, you should take action now.

SOEL Health

We have received confirmation that there will be no fully integrated SOEL Health system to system solution for prior approval. SOE’s commitment to the delivery of ePrior Approval and eOrthodontic payment and approval in EXACT is not impacted and remains unchanged. 

100% of all practices with SOEL Health have now been issued with web form usernames and passwords.

Systems for Dentists (SFD)

Live rollout fully completed.

WYSdom

Live rollout fully completed.

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.  Paper submissions received beyond this date will not be accepted, and will be returned to you.

Our testing team have completed the functional testing of the changes implemented by our supplier. At the December eDental payment and approval project board, the group discussed the reasons behind delaying the live release to around the end of January.

While the release could have gone ahead as planned, the team’s main focus is to ensure the delivered system is robust and reliable. The delay in the legislative timescales to 1 January 2020 has given the team an opportunity to further refine performance.

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.

eOrthodontic payment and approval supplier progress

We are in the process of revamping our PMS supplier page by creating a new one specifically for eOrtho.  This will be published as soon as possible. 

As at 20 December 2018, two PMS suppliers have confirmed they will not be offering a fully integrated system to system solution and have no plans to further develop their software; Goodteith and SOEL Health (SoE Exact is still committed to delivering eOrtho). 

A third PMS supplier, Dentally has confirmed that due to a lack of customer demand, they won’t be undertaking development at this stage.  They have, however, stated that they are committed to future work.

 

PMS Supplier

Current position

AssisOrtho

Committed and currently in development/running early fit for purpose testing

 

Carestream

Committed and confirmed changes will be delivered in accordance with 1 January 2020 date

 

Computer Surgery

No confirmation received

 

Dentally

Due to lack of customer demand, won’t be undertaking development at this stage.  Committed to other future work

 

Systems for Dentists (SFD)

Committed and in accreditation stage

 

Software of Excellence (SoE) -Exact

Committed and currently in development

Orthotrac

Verbally committed to deliver in time with legislative date, but no confirmation of dates received

 

Wysdom

Committed to delivering eOrtho but unable to commit to deliver by 1 January 2020 at this stage.

 

 

To understand the position of each PMS supplier, view the eOrthodontic PMS supplier page.

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