Ophthalmic Payments

Ophthalmic Payments

National User Group Meeting 2nd July 2009

Closed Change Requests2981 Newcastle, CSV option within Post Payment Checks reports

6th February 2009

2986 Dudley, Preset list box for domiciliary visit reasons on Pre Notify Visits

12th February2009

2740 Stockport, Permit practitioner name reuse

3rd March 2009

Closed Change Requests2992 Birmingham, Parameter to allow warning on input of individual GOS claim if claim is inappropriate to the contractor

18th May 2009

2838 Kent, Email payment statements

11th June 2009

Open Change Requests

2742 Dorset (on hold for discussion today)

Batched Additional Services claims

2851 Hampshire (on pilot but requires further discussion today)

Improve linking of pre-notification lists to residential homes

3084 Dudley Retain practice code for entry of next individual claim

3092 Suffolk Claims user role to include pre-notification premises details


3105 Kent Private Sight Test statements, including email option

3106 Kent Statement adjustment fields (+/-) for Glaucoma

3110 Lancashire Submission date shown for batches when approving/rejecting electronic claims

3122 Birmingham Frequency of re-test reason report to include sub-setting by practice


3123 Cambridge Select payment cycle when using EC batch approval

3124 LASCA 6 more local enhanced service codes

3125 LASCA Batched Additional Services claims

Batched Additional Service claims CR 2742

• Questions– Is there someone from Dorset

present ?– Is there enough support from you to

prioritise this change request ?– Do you wish to reject it ?

Import Pre-notification detailsCR 2851

• Pilot at Hampshire– Started on 13th February 2009

• Pilot has raised some issues and questions


• Issues– Usage of at least 6 different forms

• None of them complete for import process

• Other data item issues

– Involvement of Domi Eye Care Committee


• Questions– Is there enough support from you to

complete this change request

– Agreement to use standard form– Ask CfH to build new form based on

official form to enable import process

Proposed import form

Electronic StatementsCR 2838

• Setup

• Sending electronic statements

• NHS Ophthalmic Decrypt Utility

• Available downloads


• Setup– Sending email address

• Set email address for your Payment Authority

– Practice email address & password• Practitioner electronic claims settings

• Sending payment statements– All statement reports (email option)

Electronic StatementsSending email address

Electronic StatementsPractice email & password

Electronic StatementsSending emails


• NHS Ophthalmic Decrypt Utility

– All electronic statements are encrypted

– A practice can use our decrypt utility for free but

– Agrees to terms & conditions of use


• Available downloads

– User guide– FAQs– NHS Ophthalmic Payments Decrypt

Utility Overview & file– NHS Ophthalmic Payments Decrypt

Utility terms & conditions of use

Electronic Links Project

• Phase I - Activity Details

– 175 activation requests processed– 156 active stores– 92 stores using automatic process– 64 PCTs– 33 payment agencies


• Phase I - Claims Volumes

– Period May 2007 – July 2009• 611,618 manual approvals• 704,011 automatic approvals• 1,370,058 total claims


• Phase II – GOS3, GOS4 & GOS5

– NHS development completed for April 2009

– Ocuco have sent test GOS3, GOS4 & GOS5 claims for processing

– No supplier asked to be accredited to submit GOS3, GOS4 or GOS5 claims


• Best Practice

– Specsavers IT guide published by end July 2009

– NHS CfH published advice on possible duplicates


• Possible Duplicates– More individual GOS1 claims stored

– More possible duplicate claims identified

– Raised questions regarding the GOS Regulations when a patient is tested and advised otherwise on their previous sight test date


• Possible Duplicates– DoH response:

• providing that the sight test is done in good faith, claim should be paid

• a matter of judgement locally as to whether the PCT thinks the patient was deceptive or mistaken and then whether they want to pursue


• Possible Duplicates– Electronic Processing changes for

possible duplicates:• Improve validation checks to enable

PCT to control how to proceed on each possible duplicate claim

• Listing screen updated to show possible duplicate claims separately


• Accreditation

– Optix• first Optix pilot site active on 7th July

2009 (Collison’s)

LHB Restructuring & Ophthalmic Payments

• New LHBs commence on 1st October 2009

• Implemented within Ophthalmic system during October 2009– following final September / October

payment within each Paying Organisation

– 1 day migration process


• LHB Migration Data menu

– Practitioner Reference List– Supplementary Reference List– Migration Details

• Menu to be removed once migration completed

LHB Migration Data menu

Practitioner Reference List

Practitioner Reference Edit

New LHB Organisations

Practitioner Reference Edit

Supplementary Reference List

LHB Migration Details


• Time table– Migration Data menu active 15th July– LHBs to complete migration

reference data by 7th September 2009

– Proposed migration date• BT LHBs – 7th October• IM LHBs – 14th October• NW LHBs – 12th October


• Prior to processing the Monthly Cleardown for payment Sept – Oct

– If your LHB codes are changing, contact the National Help Desk (01392 251289)

– Raise a Priority 1 call, requesting further advice regarding your LHB migration and next payment cycle

– Do not execute the Monthly Cleardown process for payment Sept – Oct


• Prior to processing the Monthly Cleardown for payment Sept – Oct

– Do not open another payment cycle for the next payment (Oct – Nov)

– Await further instruction from the Ophthalmic Payments team regarding the processing of your LHB migration and your next payment cycle


• Issues

– Migrating Mobile Practices

– Duplicate Local Practitioner Codes

– Exeter BP screen is not affected by restructuring and is available to use for payment of September / October payment


• Issues

– Access to archive information

• use View Old Organisations Only to access this information using the menus

• not all menu functions are available to old organisations

Organisation contact details

• Requested at last OPUG meeting 22nd January 2009

– Activated on 28th April 2009• 121 organisations with missing details

– On 1st July 2009• 15 organisations with missing details

Ophthalmic Payments

Documents

Transcript of Ophthalmic Payments