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Ophthalmic Payments. National User Group Meeting 21 st January 2010. Electronic Links. Activity Details 201 activation requests processed 192 active stores 182 Specsavers 8 Optix practices 1 Vision Express 1 Independent 109 stores using automatic process
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Ophthalmic Payments National User Group Meeting 21st January 2010
Electronic Links • Activity Details • 201 activation requests processed • 192 active stores • 182 Specsavers • 8 Optix practices • 1 Vision Express • 1 Independent • 109 stores using automatic process • 83 PCTs over 42 payment agencies
Electronic Links • Claims Volumes • Period May 2007 – Jan 2010 • 919,581 manual approvals • 1,055,749 automatic approvals • 1,975,330 total claims
Electronic Links • GOS 6 claims • Pilot expected with Healthcall • Early in 2010 • Pilot site within West Yorkshire CSA
Electronic Links • GOS 3, GOS 4 & GOS 5 • NHS development completed for April 2009 • Ocuco have sent test GOS 3, GOS 4 & GOS 5 claims for processing • No supplier asked to be accredited to submit GOS 3, GOS 4 or GOS 5 claims to live payment system
Electronic Links • Processing Possible Duplicates • More individual GOS 1 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 • Processing 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
Electronic Links • Processing Possible Duplicates • Electronic processing changes for possible duplicates: • validation checks updated to enable PCT to control how to proceed on each possible duplicate claim indentified • Check Possible Duplicate Electronic Claims menu to list possible duplicate claims
Electronic Links • Processing Possible Duplicates • Manual approval changes for possible duplicates: • extended duplicate check automatically enabled on approval • all patients previous claims available for viewing
Import Pre-notification detailsCR 2851 • Pilot at Hampshire • Started on 13th February 2009 • Completed on 3rd November 2009 • Released Nationally on 4th December 2009 • Refer to online help prior to use
Import Pre-notification detailsCR 2851 • Excel form approved by Domi Eye Care Committee, FODO, AOP and OPUG • New form available from import screen & online help • Encryption to protect patient details • NHS Ophthalmic Encryption Utility
NHS Ophthalmic Encryption Utility • Practice responsible for protecting patient data • Practice can use this utility for free • Utility has ability to:- • encrypt a data file for transmission • decrypt files with .ecf extension
NHS Ophthalmic Encryption Utility • Available to NHS personnel only at https://nww.openexeter.nhs.uk/nhsia/opthelp/Ophthalmics/eng/indexElectronic.html • Pass the utility to the practice • Terms & conditions for use apply • FAQ’s available
English GOS Fees 2010/2011 • Voucher values and sight test values will be available on 1st April 2010 • No back pay for 2010/2011
Welsh GOS Fees 2010/2011 • Voucher values and sight test values should be available on 1st April 2010 • Possibly no back pay for 2010/2011 • Waiting for confirmation from the Welsh Assembly
LHB Restructuring & Ophthalmic Payments • Completed during October 2009 • No outstanding issues