Transcript Ophthalmic Payments - Health and Social Care Information

Ophthalmic Payments
National User Group Meeting
2nd July 2009
Closed Change Requests
2981 Newcastle, CSV
6th February 2009
option within Post
Payment Checks reports
2986 Dudley, Preset list 12th February2009
box for domiciliary visit
reasons on Pre Notify
Visits
2740 Stockport, Permit
3rd March 2009
practitioner name reuse
Closed Change Requests
2992 Birmingham,
Parameter to allow
warning on input of
individual GOS claim if
claim is inappropriate to
the contractor
2838 Kent, Email
payment statements
18th May 2009
11th June 2009
Open Change Requests
2742 Dorset (on hold for Batched Additional
discussion today)
Services claims
2851 Hampshire (on
pilot but requires further
discussion today)
3084 Dudley
Improve linking of prenotification lists to
residential homes
Retain practice code for
entry of next individual
claim
3092 Suffolk
Claims user role to
include pre-notification
premises details
Open Change Requests
3105 Kent
3106 Kent
3110 Lancashire
3122 Birmingham
Private Sight Test
statements, including
email option
Statement adjustment
fields (+/-) for Glaucoma
Submission date shown
for batches when
approving/rejecting
electronic claims
Frequency of re-test
reason report to include
sub-setting by practice
Open Change Requests
3123 Cambridge
3124 LASCA
3125 LASCA
Select payment cycle
when using EC batch
approval
6 more local enhanced
service codes
Batched Additional
Services claims
Batched Additional Service
claims CR 2742
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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 details
CR 2851
•
Pilot at Hampshire
– Started on 13th February 2009
•
Pilot has raised some issues and
questions
Import Pre-notification details
CR 2851
•
Issues
– Usage of at least 6 different forms
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None of them complete for import
process
Other data item issues
– Involvement of Domi Eye Care
Committee
Import Pre-notification details
CR 2851
•
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 Statements
CR 2838
•
Setup
•
Sending electronic statements
•
NHS Ophthalmic Decrypt Utility
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Available downloads
Electronic Statements
CR 2838
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Setup
– Sending email address
•
Set email address for your Payment
Authority
– Practice email address & password
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•
Practitioner electronic claims settings
Sending payment statements
– All statement reports (email option)
Electronic Statements
Sending email address
Electronic Statements
Practice email & password
Electronic Statements
Sending emails
Electronic Statements
CR 2838
•
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
Electronic Statements
CR 2838
•
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
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175 activation requests processed
156 active stores
92 stores using automatic process
64 PCTs
33 payment agencies
Electronic Links Project
•
Phase I - Claims Volumes
– Period May 2007 – July 2009
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611,618 manual approvals
704,011 automatic approvals
1,370,058 total claims
Electronic Links Project
•
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
Electronic Links Project
•
Best Practice
– Specsavers IT guide published by
end July 2009
– NHS CfH published advice on
possible duplicates
Electronic Links Project
•
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
Electronic Links Project
•
Possible Duplicates
– DoH response:
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providing that the sight test is done in
good faith, claim should be paid
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a matter of judgement locally as to
whether the PCT thinks the patient
was deceptive or mistaken and then
whether they want to pursue
Electronic Links Project
•
Possible Duplicates
– Electronic Processing changes for
possible duplicates:
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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
Electronic Links Project
•
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 Restructuring & Ophthalmic
Payments
• 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
LHB Restructuring & Ophthalmic
Payments
• 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
LHB Restructuring & Ophthalmic
Payments
• 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
LHB Restructuring & Ophthalmic
Payments
• 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
LHB Restructuring & Ophthalmic
Payments
• 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
LHB Restructuring & Ophthalmic
Payments
• 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