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Ophthalmic Payments

Ophthalmic Payments. National User Group Meeting 2 nd July 2009. Closed Change Requests. Closed Change Requests. Open Change Requests. Open Change Requests. Open Change Requests. Batched Additional Service claims CR 2742. Questions Is there someone from Dorset present ?

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Ophthalmic Payments

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  1. Ophthalmic Payments National User Group Meeting 2nd July 2009

  2. Closed Change Requests

  3. Closed Change Requests

  4. Open Change Requests

  5. Open Change Requests

  6. Open Change Requests

  7. 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 ?

  8. Import Pre-notification detailsCR 2851 • Pilot at Hampshire • Started on 13th February 2009 • Pilot has raised some issues and questions

  9. Import Pre-notification detailsCR 2851 • 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

  10. Import Pre-notification detailsCR 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

  11. Proposed import form

  12. Electronic StatementsCR 2838 • Setup • Sending electronic statements • NHS Ophthalmic Decrypt Utility • Available downloads

  13. Electronic StatementsCR 2838 • 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)

  14. Electronic StatementsSending email address

  15. Electronic StatementsPractice email & password

  16. Electronic StatementsSending emails

  17. Electronic StatementsCR 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

  18. Electronic StatementsCR 2838 • Available downloads • User guide • FAQs • NHS Ophthalmic Payments Decrypt Utility Overview & file • NHS Ophthalmic Payments Decrypt Utility terms & conditions of use

  19. Electronic Links Project • Phase I - Activity Details • 175 activation requests processed • 156 active stores • 92 stores using automatic process • 64 PCTs • 33 payment agencies

  20. Electronic Links Project • Phase I - Claims Volumes • Period May 2007 – July 2009 • 611,618 manual approvals • 704,011 automatic approvals • 1,370,058 total claims

  21. 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

  22. Electronic Links Project • Best Practice • Specsavers IT guide published by end July 2009 • NHS CfH published advice on possible duplicates

  23. 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

  24. Electronic Links Project • 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

  25. Electronic Links Project • 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

  26. Electronic Links Project • Accreditation • Optix • first Optix pilot site active on 7th July 2009 (Collison’s)

  27. 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

  28. LHB Restructuring & Ophthalmic Payments • LHB Migration Data menu • Practitioner Reference List • Supplementary Reference List • Migration Details • Menu to be removed once migration completed

  29. LHB Migration Data menu

  30. Practitioner Reference List

  31. Practitioner Reference Edit

  32. New LHB Organisations

  33. Practitioner Reference Edit

  34. Supplementary Reference List

  35. LHB Migration Details

  36. 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

  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

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