Ophthalmic Payments

1
Ophthalmic Payments

• National User Group Meeting
• 10th May 2007

2
2006 Back Pay

• Complicated by the re-opening of PCTs
• Payment process bent to enable payment
• Once your 2006 back pay is complete, dont
  include your OLD PCTs into any payment cycles

3
2007 Back Pay

• 2007 should be a normal back pay process !

4
Electronic Links Pilot Project

• Progress
• New facilities released into live Ophthalmic
  application
• Electronic Links Web site
• Link included on main ophthalmic payment help
• Link included within Bulletin Board

5
Electronic Links Pilot Project

• Progress (cont)
• Electronic Links operation User Guide
• NHS CfH ready to start pilot
• Accreditation for suppliers

6
Electronic Links Pilot Project

• Pilot
• Specsavers have scheduled first data file
  submission around mid/late May 2007
• Specsavers Winchester will be first pilot shop
• New facilities to be used for pilot sites only

7
Processing Electronic Claims

• Valid GOS claims ready for payment, these are
  REQUESTED claims
• Requested claims can not be paid
• Requested claims can be entered into an open
  payment cycle for payment-
• Automatically
• Manually

8
Processing Electronic Claims

• Invalid GOS claims are assigned rejection codes
  and have their status set to REJECTED
• An automatic response (e-mail) is sent to the
  sender when the claim status is changed

9
Viewing Requested Claims
10
Viewing Requested Claims
11
To Approve or Reject a Requested Claim
12
Closed Change Requests
13
Closed Change Requests
14
Change Requests Prioritised New
15
Change Requests Prioritised New
16
Activity

• 861,654 GOS1 claims processed in April 2007
• 16,362,921 for GOS1 in April 2007
• 56,666 Schedule D searches in April 2007
• 15.75 GOS1 claims were individually entered
  during April 2007