Our monthly update on the project to modernise payment and prior approvals as part of the eDental programme, covering:
- All GP17-1 payment claims must be submitted electronically
- eOrtho payment and approval
- ePrior Approval
- The rollout of our eDental web form
- Changes being made to the web form
- What stage practice management system (PMS) suppliers are at on the path to accreditation and rollout
- eDental transition update for all Electronic Data Interchange (EDI) practices
All GP17-1 payment claims must now be submitted electronically
All GP17-1 payment claims submitted now must be sent electronically. If we receive any claims for payment on paper, they are now being returned to practices for electronic submission. Please also keep in mind, that all claims must be submitted within 3 months of the date of completion. To the best of our knowledge, we, and/or PMS suppliers have contacted all those who have not yet moved over from paper to discuss arrangements; either providing an interim solution of the web form, or holding claims until such time as the practice is ready to transition. If you still have nothing in place, you must take action now.
Contact the transition team on firstname.lastname@example.org or 0131 275 6866.
eOrtho payment and approval
Our internal suppliers are continuing with their development for Orthodontic payments and prior approvals. We have not as yet received a response from PMS suppliers on the orthodontic system specification that was issued in October 2017. A meeting has now been arranged with all PMS suppliers in February to discuss upcoming changes, of which Orthodontic payment and approvals is part. You are reminded that paper submissions for Orthodontic Prior Approval requests and payments will no longer be accepted after 1 January 2019.
The new ePrior Approval system is being implemented in 3 releases. The first two releases have been implemented and the third will be on the weekend of the 20 January. Following some post implementation checks, we anticipate the live early adopter pilot phase will commence on the 24 January with web form users. We will contact the web form practices to advise of their next steps.
One PMS supplier has provided an indication of timescales to begin the testing process with us. Details can be found on our PMS supplier page. Each supplier must undertake fit for purpose testing and e-prior approval accreditation testing before practice management suppliers can roll the changes out to their customers. All paper GP17-1 prior approval requests must be submitted electronically from 1 October 2018 and paper requests will no longer be accepted beyond that date.
eDental web form rollout
38 out of the planned 42 practices anticipated to use the webform have now moved across. Some practices who submitted paper previously and were due to move across to a PMS supplier, are not in a position to do so. As an interim solution, 9 practices are being added to the web form list; a number of which are now live.
Changes being made to the web form
In our December update we advised that we were making changes to the web form screens. We do not, as yet, have a date for implementation, although we have now implemented the following rule changes:
Error returned if a claim is submitted with a patient charge of zero and an exemption code of HC3. Unfortunately, this meant the rule was also applied in cases where no treatments had been claimed or the total of the treatments expected a £0 patient contribution, for example a basic examination. This will now accept a zero patient charge, with an exemption of HC3.
Error returned where item 4600 has been claimed but where claim type 5 (referred patient) has not been selected. This rule has been extended to cover Item 4405.
Error returned if item 18(a)-(f)(2) is included on a claim, but item 2b is not included and the models available flag has not been selected. This rule has been extended to cover item 29(D).
New rule - Error E000727
A new rule has been added to ensure that no fee shall be payable under item 48, in connection with any treatment other than item 57 (domiciliary visits and recalled attendance).
Practice management system (PMS) supplier update
As at 16 January, four PMS suppliers are accredited and in the process of transition or complete - these are Carestream (R4+), Goodteith software, Software of Excellence (SoE) (Exact and SOEL Health) and Systems for Dentists (SFD). If you use a PMS, or intend to start using one to claim for payments in future, our practice management systems page contains additional information on where each PMS supplier is on their path to accreditation and rollout.
Feedback from suppliers suggests that they are still continuing to come across practices with issues at the point of transition, primarily as a result of PCs needing replaced, and in particular, Microsoft XP machines. If you still have old machines, please take action now.
eDental transition update for all Electronic Data Interchange (EDI) practices
With practices at different stages of transition with their chosen supplier, we want to ensure that practices have the information they need to manage their transition effectively. As well as communicating directly with each transitioning practice, we also have some general eDental transition updates which practices may find useful. These updates cover:
- transition update for Goodteith practices
- transition update for Software of Excellence (SoE) practices
- transition update for Systems for Dentists (SFD) practices
We’ve also created some eDental advice and tips for practices. Our eDental advice article covers top tips for a smooth transition to eDental as well as ways to improve your claim turnaround when submitting eDental claims.