The following is a list of enhancements included in R4+ Version 8.5.2. All fixes are cumulative (each new release contains all new fixes as well as all fixes from the previous release).
As part of the ongoing project of Dental Reform in Scotland, several changes come into effect for New Dental Courses of Treatment from August 1st, 2024, as follows:
New Bridge Type Annotations to record the purpose of each position within the Bridge.
Reinstated Materials for use with Crowns, Veneers & Inlays.
New D001 Type Annotations to record various usage as a Crown or Bridge. (See Note below.)
New Core & Post Type Annotations to record the Fabrication & Material used. (See Note below.)
New FP17 Dental Claim Examination Metrics for Courses involving an Item 1a Examination. (See Note below.)
New FP17 Dental Claim Treatment Reason Capture for Courses involving an Item 1c Examination.
There are important points to be aware of regarding these Regulatory Changes:
D001, due to its multiple use nature, is currently identified by default as a Crown. When used, it will prompt for its use as a Crown or a Bridge in each Tooth's position.
Where Item 1(a) Treatment is present, the Examination Tooth Counts will calculate based on the current state of the mouth, allowing for review and correction as necessary before FP17 transmission. Highest BPE will also be harvested if a suitable BPE exists on the Patient Record. These captures are Patient age controlled so are unused for Under 7’s, Optional between 7 and 18, and Required from 18 and older, based on Date of Acceptance.
We have implemented Integration Support for 3Shape Unite. This requires the 3Shape Command Line Interface to be installed from the 3Shape App Store alongside R4+ and the 3Shape Unite Software on each Workstation.
This can then be enabled through the Clinical Chart > Tools > Options > X-Ray Programs tab. The 3Shape Unite default plug-in location is the assumed path, but can be changed by browsing to the DentalDesktopCmd.exe location if a Workstation used a custom 3Shape Unite installation location instead.
This Integration allows the Patient Details to be shared with 3Shape Unite to Create, Merge or Update Patient Records between the two systems.
This update process is one way from R4+ to 3Shape Unite so any changes to Patients' Personal Details should always be maintained primarily in R4+ and then synchronised to 3Shape Unite.
Further details on enabling this Integration can be found under the How To section in the 3Shape Help Center.
Any Course of Treatment started on or after August 1st, 2024, falls into the SDR Reform Part 2 requirements for FP17 Transmission. A small issue was identified where if the Course contained a A003 Treatment Code but was Deleted, the FP17 Claim was still expecting Treatment Reason to be provided for Transmission. This has been fixed in R4+ v8.5.2.
After further discussions with PSD on specifically which Treatment Codes and Situations are expected to be counted towards the Restoration or Extraction Count at the point of Examination, the following Treatments will now be Uniquely Counted by Affected Tooth unless Deleted before Course Completion.
Fillings: C001, C002, C003, C006, C007, C008, C009, C012 & C013
Crown, Post/& Core, Inlay/Onlay & Veneers: D001, D002, D003, D004, D005, D006, D007, D008, D009, D010, D011, D019 & D020
Extractions: E001, E002 & E003
Bridges: D012, D013, D014, D015, D016, D017
These changes will take effect on any subsequent Completed Courses producing new FP17 Claims after upgrade. Any Claims already produced before upgrade with a Count deemed incorrect will continue to require manual amendment before Transmission. This has been fixed in R4+ v8.5.2.
Previously all combinations of Type and Material Options were made available where Treatment Codes D005, D019 or D020 were used, this could result in Rejections from MIDAS due to unexpected combinations being selected. To avoid this, we have applied Filtering Rules based on PSD Expected combinations to avoid these problems and has now been fixed in R4+ v8.5.2.
Any E002022 or E002023 Rejected Prior Approval or Final Payment Claims on or after August 1st, 2024, which include these treatments will require reopening the Course, Deleting then Replacing with fresh Treatment Codes, selecting the expected valid Type and available Material, Recompleting then Resubmitting the affected Claim.
Any New NHS Course of Treatment started & completed on or after August 1st, 2024, would include and Transmit the Total Tooth & Requiring Restoration Counts where an A001 Treatment Code is not included in the Course. While this does not result in Claim Rejection, it may raise Questions as to why it is Present.
To avoid unnecessary delays in Claim processing, we have made changes so the Count Calculations will continue to occur to ensure data has been recorded when needed, but will then only be included in the actual FP17 Claim Transmission to MIDAS if A001 is also present and completed. This has been fixed in R4+ v8.5.2.
Where Treatment Code D012 has been used to Span any Missing Teeth positions as to provide a Pontic in those spaces, previously the user would not be allowed to Complete the Treatment due to the Tooth not being Present. This was due to legacy validation that is no longer applicable to this SDR Reform Treatment and has now been fixed in R4+ v8.5.2.
Where two of the same G004, G005 or G006 Treatment Codes have been used to present a Full Upper & Lower Denture, this would produce a malformed PA and Final Payment Claims resulting in Claim Rejections with a Status of RAI from MIDAS. This was due to differences between the previously Unique Full, Upper and Lower Treatments and the more Generic replacement SDR Reform Treatments that are used in all three situations. This has been fixed in R4+ v8.5.2.
Any currently Rejected Prior Approval or Final Payment Claims with RAI status on or after August 1st, 2024, that include these treatments will require reopening the Course, Deleting then replacing with fresh Treatment Codes, Recompleting and Resubmitting the affected Claim.
Where Treatment Codes G002, G003, G004 or G006 have been used, R4+ would prompt if you would like to include an Extraction for each Tooth Affected. This was due to legacy validation that is not applicable to these SDR Reform Treatments. This has been fixed in R4+ v8.5.2.
Two issues could affect the Clinical Note for we have made several improvements to Clinical Charting to aid Clinicians under SDR Reform as follows:
Post & Core D005, D019 & D020 Treatments will now Record the used Material in the Item Description and Clinical Note.
Editing a Previously Proposed Crown to amend its Material will no longer result in the Clinical Note losing Material Information.
These have been fixed in R4+ v8.5.2.
We have made several improvements to Clinical Charting to aid Clinicians under SDR Reform as follows:
Post & Core Treatments will now Present in the Odontograph based using the expected Colours for the Material Selected.
Carbon Fibre Material will now save any Custom Colour change made by individual Clinicians through the Chart Tools Screen.
Type and Material Selection Prompts will now appear adjacent to the Code Selector based on Screen position instead of In-front so the Clinician can now still see the Treatment Code being applied.
Type and Material Selection Prompts will now adhere to the Clinician's Selected Tooth Numbering System, instead of supporting only British.
These changes have been made in R4+ v8.5.2.
When a Course is Closed and the Final FP17 Claim is produced, the Exam Tooth Count Calculations also take place. If the user needs to retrospectively adjust the Acceptance Date prior to August 1st, 2024, these values are lost, so if the Claim’s date is reset or adjusted back from August 1st, 2024, the Counts remains lost. This has been fixed in R4+ v8.5.2.
Due to changes made over time in Tandem with the eOrtho Project, some DPB Codes requiring a Prior Approval could result in missing Prior Approval requests where expected if an R4+ Installation occurred since 2018. We have made changes so this information is included in all required Code Updates to ensure no data gaps occur simply due to the point of time an Installation occurred. This has been fixed in R4+ v8.5.2.
Due to differences between how the two available SMS Providers process and respond to SMS Message requests, this could result in two different possible problems affecting both the SMSs received by the Patient and associated Planned Appointments statuses.
HCL: if an Appointment Card was sent to the Patient the same day as an Appointment Reminder, the Appointment Card would be discarded and not received by the Patient. This was incorrect as the Two SMS Messages are unique serving different purposes and could result in Missed Appointments.
Patient Comms: An Appointment Card would carry the same Identifier as an Appointment Reminder, meaning it was possible for any Patient Response (accidental or otherwise) to an Appt Card to unexpectedly affect the Confirmation Status of the outstanding Appointment resulting in either Missed or Accidentally Cancelled Appointments.
These issues have been fixed in R4+ v8.5.2.