These release notes describe the most important changes/fixes in version 6.5.2 of the CS R4+ software.
We have added the following code and fee changes which come into effect from November 1st, 2018 for all accepted new courses of treatment for all Scottish NHS Sites:
NHS Fee Increase of 2.55% across all applicable Treatment Codes.
General fee rounding to nearest 5p for all applicable Treatment Codes.
Specific fee rounding to nearest 1p for Treatment Codes 4101, 4102 & 4111.
Correction to Treatment Code 3222 which was incorrectly set as a discretionary code.
The board have updated the prior approval limit from £390 to £410, this change takes immediate effect on accepted courses from November 1st, 2018. We also check and update any individual tiered limit actively below this to ensure the new base limit is adhered too from this date forwards.
Under certain conditions and workflows in previous releases of CS R4+ it was possible for new unique claims being perceived as duplicates of claims already transmitted for processing, this would result in the new claim being rejected with a range of specific error codes E000509, E000602, E001007 or E001008. We have made further improvements to detect claims in this state, correct the DSR number and reset the claim to ‘Not Ready’ to allow re-encode and re-submission.
Please be aware due to this fix you may see a sudden increase in the number of ‘Not Ready’ eDental claims that require transmission, some may also prompt for new CHI Patient Searches to ensure successful transmission.
An issue was recently identified when processing a reconciliation file received after a Prior Approval claim was approved for payment by the board. CS R4+ would update the original Prior Approval request leaving the claim in a Sent state, this has now been fixed so the Prior Approved payment claim is always updated if a response is found during claim response processing.
We have identified a weakness that contributes to eDental claims being seen incorrectly as duplicates and thus subsequently rejected with an E000509 error, we have improved the DSR field shown on the List No tab on the Users window so it checks to ensure the value present is correct for the list number that has been specified and if not automatically adjust the value to where it should be for a given list number.
This also means from this release forwards DSR number is now edited and changed separately to a user’s list number to always ensure this number never overlaps with a previously used number, this fix is automatic and requires no input from the end user.
An issue was recently identified where if a site has any non-numeric list number when a reconciliation file is received, and a user chooses to process it would start processing, but error due to the invalid list number and stop, but still report the file as processed.
This would leave claims in statuses like Sent or Rejected due to already been processed if reset, we have addressed the issue and will automatically mark all previously received reconciliation files for re-processing in this release.
Please be aware due to this fix when accessing your EDI search window, you will be prompted you have Reconciliation responses for processing as this contains all previously received Reconciliation files to-date this may take some time to complete during which that workstation will be unusable so plan accordingly.
Do not interrupt this process when started during which time CS R4+ may become unresponsive, but will return to normal once completed. Finally, you may see a sudden increase in ‘Adjusted’ claims that may require manual settlement due to this reprocessing activity.
An issue was recently identified in the recently added Prior Approval tab implemented in v6.5.0 which affects only paper-based approvals, Prior Approvals granted on paper require only the Date of Approval to be provided in the Final Payment claim as no Reference code is provided.
Where only a Date of Approval was present this would be missing on the transmitted claim causing the board to reject with either E000801 or E000804 errors. We have addressed this issue and will also detect affected claims and mark their status back as ‘Not Ready’.
Please be aware due to this fix you may see a sudden increase in the number of ‘Not Ready’ eDental claims that require transmission, if any are found with an Invalid Prior Approval Reference present this will also be cleared from the claim and require re-adding from the Web Portal.
An issue was recently identified affecting Prior Approved payment claims where if the patient failed to return the Prior Approval tab was hidden stopping the user from providing the PA authorisation required for the treatment involved causing a rejection (E000801 or E00804). This has been corrected allowing a Prior Approved payment claim to be marked as FTR and still allow the PA authorisation to be entered via the Prior Approval tab.
Paper Based: only the Date of Approval must be completed, this will be supplied on the paper approval itself.
Portal Based: The Date of Approval & Reference must be completed, these are supplied on the web portal for the approved request (do not enter date into the reference field).
An issue was recently identified affecting larger sites like PCT’s where processing of any pending Reconciliation files would continually fail and report to the user that there have been problems processing the file, we have now addressed this problem which has also resulted in a performance improvement in processing reconciliation files.
An issue was recently identified affecting some sites that had SQL Transaction Replication active which would result in all eDental functionality no longer working, after investigation this was found to be caused by the default replication limit that SQL uses being 64Kb however certain eDental claim files could be larger causing SQL to fail writing data to the database.
We have addressed this by detecting where needed, if default limit is present and then increasing this to 10Mb which is larger than the largest file received so also provides future scope for any further file size increase overtime.