The following is a list of enhancements included in R4+ Version 8.8.0. All fixes are cumulative (each new release contains all new fixes as well as all fixes from the previous release).
We have implemented Patient Record integration between R4+ DPMS and VistaSoft Imaging Software. This integration must be enabled in both VistaSoft and R4+.
In R4+, the integration is enabled under Clinical Chart > Tools > X-Ray Programs on each workstation.
In VistaSoft, this integration is enabled via the Configuration > Interface > Enable VDDS option, then selecting R4+ DPMS from the drop-down.
If enabling in VistaSoft first, you will need to return to the VistaSoft Configuration> Interface screen again after activating in R4+ to select R4+ DPMS before use.
A new icon is now present on the Imaging Toolbar within the Clinical Chart to allow launching VistaSoft to access the Loaded Patients Images.
After activation, R4+ will support the transfer of the following
Patient Information to VistaSoft as well as any amendments made to a Patient's Name, Gender, Date of Birth, or Address in the R4+ Patient Record when next launched:
Patient External Reference
Patient Forename & Surname
Patient Gender & Date of Birth
Patient Address
Since the introduction of SDR Reform, the prior Filling Fee Codes were expired from use with the introduction of new Generic Filling Fee Supplements, depending on various conditions like the type of filling and tooth affected. However, where R4+ would previously automatically propose the required fee alongside a filling, since the SDR Reform, clinicians were expected to manually add any required Supplements themselves as needed. This resulted in Supplements sometimes being missed resulting in underpayment.
R4+ is re-introducing the automatic proposal of Filling Supplements in NHS Courses of Treatments. However, this cannot be completely automated under the new SDR Reform Supplement Rules.
Automatic Supplement addition will only apply to Resin Material fillings per the SDR.
Due to the complexity involved with the new SDR rules, the Calendar Time Rule is not being applied to any of these Supplements. This means that if a Supplement is accepted for a given tooth in a claim and another claim uses the same Supplement on the same tooth for the same Patient within 11 Months, the second supplement will not be accepted. This might result in claim rejections from MIDAS as E002010; in which case, the affected Course should be reopened, the Supplement removed, recompleted, and the Claim resubmitted.
For Posterior Supplement 3(e) where the filling is on the mesial and/or distal marginal ridge of a premolar or molar tooth, there are additional conditions specific to Age, Pregnancy, Breast Feeding or External Recommendations. Most of these are observed based on Patient's Date of Birth vs. the Course Date of Acceptance and if the Patient has either the Pregnant or Had Baby within 12 Months exemption active.
However, the Letter Recommendation cannot be observed, so clinicians will need to add any necessary 3(e) Supplement manually in that instance.
If multiple fillings are applied to the same tooth, then only the most suitable supplement will be applied automatically. Likewise, a Supplement can only be automatically added once even if two of the same fillings are added to the same tooth. This is to observe the unique Supplement rule per Tooth within the same Claim MIDAS Rule.
If different combinations of fillings are applied to the same tooth, R4+ will deduce the best combination of unique Supplements allowed by MIDAS. This considers mixed material situations where only one of the fillings is resin where multiple single and/or combination fillings are used to determine the expected Supplement(s).
Clinicians can still choose to delete any Automatic Supplement(s) proposed or manually add further Supplements alongside any Treatments they deem fit to include during a Course of Treatment.
The HSCNI have been asked by the BSO to introduce the Universal Credit Exemption to collate information in relation to patients who attend for Dental Treatment. Patients are now able to access the Universal Credit Exemption on their Patient Record > Schemes Tab and with new FP17 claims from August 31st, 2025.
R4+ v8.8.0 will now support SQL 2022; however, it will only currently allow an In Situ upgrade of the existing SQL Server version that is already present alongside R4+. This is to allow customers an immediate upgrade path given that SQL 2019 is no longer in Mainstream Support as of February 28th, 2025 (Extended Support to January 8th, 2030). The ability to undertake Fresh Installs with SQL 2022 will be available in an upcoming release.
When processing a Reconciliation file, if a List Numbers Schedule is returned with FP17 DSR claims that cannot be matched within the Database, this resulted in the entire Schedule not being processed and an ambiguous error was recorded to indicate there was a problem. This was leaving unaffected claims in the same Schedule unprocessed.
This has been improved so all successful FP17 DSR claim matches within a Schedule will now be processed. Any DSR claims that fail to match will be specifically recorded in the error, alongside the Schedule and List Number that could not be processed, to aid investigation under the View Reconciliation File Errors screen. This issue has been fixed in R4+ v8.8.0.
When processing monthly Reconciliation files received from MIDAS, any recorded Narrative responses will now also be stored against any affected FP17 DSR claim. This makes it easier to view information returned by the board as it can be viewed in a claim's View Replies screen as well as the eDental Schedules screen. This has been fixed in R4+ v8.8.0.
Since the SDR Reform, a small issue was identified whereby any Course of Treatment that had reached the Patient Statutory Maximum Charge, with part of the Course completed before being continued to another Clinician, would cause the remainder of the Course of Treatment to recalculate a Patient Charge (instead of adhering to the charge limit reached in the preceding claim). This has been fixed in R4+ v8.8.0.
An issue was identified where if a C001 and C002 are applied to the same tooth, the <ProposedCharting> Block transmitted in the FP17 DSR claim would be malformed, resulting in an E002027 rejection. This has been fixed in R4+ v8.8.0.
When the Treatment Codes were replaced under SDR Reform, the New Examination A001 code continued to use the older Calendar Rule Check. This has been fixed in R4+ v8.8.0.
A Treatment Code was reported by a customer as not charging correctly under the NHS Occasional Schemes. After an in-depth analysis of all NHS Occasional Scheme Codes, a number were found to either not apply a correct charge split, incorrect Charge amount, or not adhere to a code's Instanced Allowed Maximum Charge limit.
This affected codes A001, A002, B003, C002, D009, D010, D013 and E004. These have been fixed in R4+ v8.8.0.
A System Administrator must log into R4+ on your App Server after completing the update. You will be prompted to import a Code Update. This must be completed to apply these changes to your system.
C012 was not correctly mapped to allow use on opposing tooth surfaces. This has been fixed in R4+ v8.8.0.
When charting a denture treatment code, as this spans multiple tooth positions normally, the Tooth ID is not recorded on the Treatments Line-Item Record as it records the upper or lower arch in its description. Since the SDR Reform, the new denture codes G004, G005 and G006 have been recording the first position of the denture incorrectly, resulting in a confusing Treatment Line-Item for clinicians. This has been fixed in R4+ v8.8.0
If after completing any filling codes on a tooth, a Carious Baseline Condition is charted on the same tooth surface at any later point of time, an error was presented on screen. This has been fixed in R4+ v8.8.0.
In certain situations, multiple fillings applied to the same tooth results in banding changes between 2A, 2B and 2C if any fillings are marked as Under Guarantee, causing the Banding to change, which could cause the patient charge to inadvertently be reinstated when not expected. This has been fixed in R4+ v8.8.0.
To aid customers in managing NHS Claims, given that Hygienists and Clinical Technicians can raise FP17’s since the introduction of Direct Access Roles, these roles are now included in the EDI Management Screen when using the All Dentists option. They are now also listed under the Dentist Search drop-down Filter. This has been fixed in R4+ v8.8.0.
An issue was identified stemming from the introduction of SDR Reform in Scotland that broke the ability to manage treatment pricelists in R4+. This has been fixed in R4+ v8.8.0.
An issue was identified where the Post Code Lookup was not negotiating a HTTPS connection when expected. This was due to an incorrect security binding stopping the R4+ API Service Connection from handshaking and negotiating a secure connection to the Third Party Endpoint. This has been fixed in R4+ v8.8.0.
Google Mail’s spam algorithm was found to cause false identification for emailed FP17DC forms. This resulted in patients not receiving email copies of their Treatment Plan. The forms stored Subject has now been changed from “FP17DC” to “FP17dc Treatment Plan – Patient Copy”, which should reduce its spam score and avoid being blocked when emailed to Google accounts. This has been fixed in R4+ v8.8.0.
Since R4+ v8.1.11, any Query Based Report attempting to use the HTML Result output option would result in an error “No Valid XML data was created”. This has been fixed in R4+ v8.8.0.
An issue was identified between viewing and printing Patient Medical Questionnaires that were taken during the NHS Capitation Prototype which results in a mismatch between the printed and on screen answers. This has been fixed in R4+ v8.8.0.