Ophthalmic Payments National User Group Meeting 16 th January 2014 Presented by Mark Green & Mark Hillman

Ophthalmic Payments Service Central Ophthalmic Payments system continues to use old PCTs as the organisational structure within England Local Code to indentify a Contractor Constrained by Organisation Code to provide unique code per contractor No changes

Ophthalmic Payments Service No longer doing a full PCT migration: –Minimise risk –Continuity of service –eGOS practices remain operational –Large effort –Small benefit Focus will be on reconfiguring the organisation hierarchy within the central Ophthalmic Payments system

Current Organisation Hierarchy

Possible Organisation Hierarchy

Ophthalmic Payments Service PCSS offices can decide to re-structure –Support log will be required –Provide new structure for organisations –Change to be implemented by HSCIC between payment cycles You will be able to log into all responsible organisations using one Open Exeter account

Ophthalmic Payments Service Grouping of organisations for payments can be changed or remain the same as today Local Contractor codes remain unchanged No additional work required for PCSS staff –But update your organisations from PCTs

Electronic Statements Background Setup Sending electronic statements Available downloads –NHS Ophthalmic Decrypt Utility

Electronic Statements Background –Payment system makes over 81,000 payments –Covers 9,849 contractors –eStatements has been identified to help reduce costs –1,400 enabled to use eStatements –New report to list eStatements details

Print Optician Statement Settings Report

Electronic Statements Setup –Sending address Set address for your Payment Authority –Practice address & password Practitioner electronic claims settings Sending payment statements –All statement reports ( option)

Electronic Statements Sending address

Electronic Statement Practice & password

Electronic Statements Sending s

Electronic Statements NHS Ophthalmic Encryption Utility (Version 1.5) –All electronic statements are encrypted for non NHS.NET accounts –A practice can use our decrypt utility for free but must –Agree to terms & conditions of use

Electronic Statements Available downloads –Data File Formats for Electronic Submission of Contractor Claims –User guide & FAQs –NHS Ophthalmic Payments Decrypt Utility Overview & file (Version 1.5) –NHS Ophthalmic Payments Decrypt Utility terms & conditions of use

Electronic Links (eGOS) Activity Details – 399 active stores 261 Specsavers stores 93 practices using the Optix system 24 Vision Express stores use Ocuco 21 Independents –125 PCT/LHBs over 54 payment agencies

Electronic Links (eGOS) Claim Volumes from May 2007 –9,289,327 GOS 1 –8,705 GOS 3 –1,581 GOS 4 –3 GOS 5 –84 GOS 6

Non CR deliverables ISFE / regulation work Performance improvements Re-platforming Ophthalmic Payments system Options for Organisation Migration

Completed Change Requests 5183Add details (apart from password) from the Contractor Payment information/Electronic Claims Settings page to the opticians list report or create a separate report. Released on 29/10/2013. Functionality is provided via: System Administrator Setup -> Opticians Details Reports -> Print Optician Statement Settings List 5433Enhance the current reports to collect the ethnicity data that is entered into the system This CR has been closed and the additional ethnic information will be available within the EHEW statistical report from the 29th August 2013.

Open Change Requests 4796Hold System to amalgamate statements based on addresses. 5032Facility be introduced on GOS3/4 at the 3 month after collection stage, to prevent old claims going through. 5108Allow duplicate statements for those performers on a list outside of Essex to be available once the monthly cleardown has occurred. Requirement needs to be clarified as the system should be able to produce Duplicate Performer Statements for all PCT areas outside of Essex. It may be that this functionality is already provided. 5140Block claims for a small glasses supplement if the patient is a child NOT Under 7 years. 5143Batched Enhanced Service Information to be included within the General Purpose Audit Report Requirement needs to be clarified. Would batched data be considered for the General Fraud Audit as there is no patient details data to check for fraud on Batched claims?

Open Change Requests 5274Facility required to upload a batch total for GOS 1's per premise from a spread sheet into OE each month. Consideration needs to be given - as we are trying to move away from “non-descript” batches and encourage more use of Electronic Links to provide more richer data for better fraud checking and more accurate control over payments to Opticians. 5323Is it possible to have asterix's marked as mandatory fields 5552Enhance the report on the General Purpose Audit Reporting screen for Additional Services to include the clinical data 5553amend the Fraud Officer access to enable Post Verification Teams to view the Statistics menu 5563PPV adjustments as separate items to any other adjustments

Service Performance - targets PriorityMaximum Response Target Maximum Resolution TargetExamples 130 minutes1 dayUnavailability of the entire system, a key module or major function, causing significant business impact. 21 hour1 dayUnavailability of the entire system, a key module or major function, causing limited business impact. 32 hours5 daysProblems causing inconvenience, minor disruption or restricting performance. 44 hoursAs agreedNon urgent problems causing slight irritation but where workarounds are available; cosmetic or general enquiries for information. 98% of reported support calls to be responded to within target 90% of reported support calls to be resolved within the target

Service Performance - achievement 2013/14AprMayJunJulAugSepOctNov No. Calls Response % - (98% target) 100 Resolution % - (90% target) Availability (%)100