Update on eDental payment and prior approval modernisation project - September 2018

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

  • eDental payment update – September 2018
  • ePrior Approval – 1 October 2018 mandated date approaches
  • Practice management system (PMS) supplier update
  • eOrtho payment and approval

eDental payment update – September 2018

If you have any queries in relation to error codes or anything related to payments, you should refer to the eDental guidance.

If you receive a Midas claim rejection letter, don’t return the letter to us with written instructions, as we cannot process the claim this way.

The claim the letter relates to must be resubmitted electronically via eDental with the necessary amendment, if payment is still being requested. 

ePrior Approval – be ready for 1 October 2018   

All prior approval requests must be submitted electronically from 1 October 2018 and paper requests will no longer be accepted beyond that date. 

Read our tips on how to avoid prior approval delays.  

With around two weeks to go, there is a concern that some practice management system (PMS) suppliers may not be ready in time for 1 October. 

PMS suppliers need to successfully complete fit for purpose testing, accreditation and beta testing before they can roll out to their practices. 

If your PMS supplier is not ready in time for 1 October 2018, you will need a web form account in order to submit your Prior Approval requests. For further information on individual suppliers, read the supplier progress section to determine whether you need a user account.

Specific Prior Approval web guidance is now available. You should read this guidance before using the web form for prior approval submission. 

Supplier progress

Each supplier is at a different stage with electronic submission of prior approval. 

A supplier must undertake fit for purpose testing and e-prior approval accreditation testing before they can roll the changes out to their customers. Following this, a supplier will move to beta phase (with a number of practices), which forms part of early rollout. 

At this stage, a PMS supplier may make improvements and then roll this out to all other sites.

We regularly update our PMS supplier page with information in relation to anticipated development and delivery dates for electronic prior approval. 

We are in the process of issuing dentists with usernames and passwords for the webform where the PMS supplier is unlikely to be rolled out in time, or where we have been advised that the changes will not be made. 

User accounts will only be created for dentists, and will not be extended to include practice staff.  We appreciate this may be a limitation for dentists, however, we only hold and have access to dentist details, and not practice staff information. 

The timescales, costs, substantial increase in users and the associated maintenance cannot be justified when the volume of prior approval requests are so small.  

We remain hopeful that PMS suppliers will develop the prior approval integrated system soon, and would encourage you as one of their customers to communicate your views to them on this matter.

You should check our PMS supplier page for the latest information.

As a guide we allow one month for fit for purpose testing, a further month for accreditation and a few weeks of beta testing before starting full rollout. While things can be turned around quickly, any issue identified at any stage that requires further development will have a knock on effect to meeting the 1 October 2018 dates.   

Carestream

Carestream have confirmed that they are committed to further developing R4+ in 2019, and this development will include prior approval.  They will not have a fully integrated system to system solution in place for prior approval for 1 October 2018.  

Practices must complete the online form now in order to submit Prior Approvals electronically using the webform from 1 October 2018.  You should do this as soon as possible.  

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. 

Your practice must complete the online form with sufficient time for this process to be carried out.

Computer Surgery

Computer Surgery are yet to commence fit for purpose (Ffp) testing. Following this, they will be required to undertake accreditation testing. On successfully passing this, they will then roll out to beta and thereafter, all practices. 

Your practice should complete the online form now in order to submit Prior Approvals electronically using the webform from 1 October 2018.

Dentally

Dentally have completed fit for purpose (Ffp) testing and will now progress to accreditation. On successfully passing accreditation, they will then be able to roll out to beta and thereafter, all practices.  

Goodteith

Goodteith have confirmed that they will not be seeking accreditation for prior approval for 1 October 2018. 

Your practice should complete the online form now in order to submit Prior Approvals electronically using the webform from 1 October 2018.

Systems for Dentists (SFD)

SFD have completed the live rollout to their practices.

Software of Excellence (SoE)

EXACT: SoE are undertaking prior approval accreditation testing. Once this has been successfully completed, they will move to a beta phase then full roll out.

SOEL Health: SoE have confirmed their decision to desist from investing further into the delivery of phase two (ePrior Approval) and phase three (eOrtho) functionality for their SOEL Health (Public Health Care ) product. 

Practices with SOEL Health have now all been issued with usernames and passwords to use the web form for submitting prior approval submissions from 1 October 2018.

WYSdom

WYSdom are yet to commence fit for purpose (Ffp) testing. Following successful Ffp, Wysdom will be required to undertake accreditation testing. On successfully passing this, they will then roll out to beta and thereafter, all practices. 

eOrtho payment and approval

Our testing team are continuing to test the changes implemented by our supplier. A first phase of testing has been completed and we are now in a final phase of testing any defects which have been resolved. 

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.  No suppliers are ready as yet to undertake Ffp.

The second part of supplier testing is accreditation and this takes place following a successful Ffp.  The accreditation process 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.  

Any supplier who then passes Ffp successfully can undertake accreditation testing from mid-end September 2018. 

Of the orthodontic specialist PMS suppliers, Assisortho, is in the development stage and Orthotrac has committed to the development.  For both specialist suppliers, we await their firmed up timescales timescales for Ffp, accreditation, beta testing and rollout. 

Three of the general practice suppliers, have now committed to the development: Carestream (R4+), Systems for Dentists (SFD) and Software of Excellence (SoE) for their EXACT software. 

SFD have confirmed they expect their testing to begin in September, and SoE are currently undertaking development.  We are awaiting timescales from Carestream (R4+).

We have added a couple of other updates to the PMS supplier pages, but we are still awaiting confirmation from others to understand what their intentions are in relation to this development. 

Paper submissions for Orthodontic Prior Approval requests and payments will no longer be accepted after 1 January 2019. 

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