Practitioner Services
Gyle Square

1 South Gyle Crescent

Edinburgh, EH12 9EB

Tel: 0131 275 6000

Text Relay: 18001 0131 275 6000

Fax: 0131 275 7266

Dental Practice

Date15/11/2017

Your RefeOrtho letter Nov 17

Enquiries toeDental helpdesk

Direct Line0131 275 6300

Continued

Dear Principal Dentist/Practice Manager

We are writing to update you on the eDental Payment and Approval Modernisation project,in relation to Orthodontic submissions, and advise of any actions you need to now take.

As you will be aware,from PCA 2017(D)01, submission of all payment and prior approval orthodontic claims must be made electronically by31 December 2018.

All practices should nowhave a Scottish Wide Area Network (SWAN) connection to the NHS. This was driven from the Strategic Vision for eDentistry which stated that from 1 April 2017:

  • all communication between NHS Boards and dentists will be via NHS email; and
  • all referrals to secondary care by dentists will be sent by SCI Gateway.

If for some reason you do not have a SWAN connection in place, contact our helpdesk on 0131 275 6300 and advise them that this is required. Please note, you will require your own internet broadband.

In August 2017, we conducted some analysis on practices submitting Orthodontic treatment. This analysis identified 3 groups of practices who undertake orthodontic treatment:

  1. Orthodontic specialist practice – all list numbers within the practice undertake orthodontic activity
  2. General practice who have at least one Orthodontic specialist list number undertaking orthodontic activity
  3. General practice who do a small amount of orthodontic activity

The vast majority of those within group 1 have an orthodontic practice management system (PMS) in place; Assisortho or Orthotrac. We previously engaged with the two suppliers about the upcoming changes. Both indicated that they intend to make the system changes required so that orthodontic claims and orthodontic prior approval requests can be submitted electronically. A formal response on the development of both systems to meet the eDental orthodontic requirements is expected following their review of the eOrtho supplier specification. The specification was issued week ending 20 October 2017.

What do I need to know right now?

What you need to do depends on whether you intend to submit orthodontic claims and prior approval requests electronically using an orthodontic specialist PMS or via a general PMS. If you are an orthodontic specialist practice and use a specialist orthodontic PMS move to step 1.1. If your practice currently uses only a general PMS or submits using paper, move to step 1.2.

1.1 My practice is an Orthodontic specialist practice

If you currently use Assisortho or Orthotrac then you should confirm with your supplier that they intend to undertake the work for eDental orthodontics. Both suppliers are aware of the timescales for implementation and we will keep you advised of progress on our web site each month once this information becomes available.

Once an Orthodontic PMS has developed and tested their system internally, there is a dependency on each supplier successfully passing Fit for Purpose (FFP) testing then payment and approval accreditation for orthodontics, prior to rollout. Electronic submissions for orthodontic activity cannot be submitted by practices until the PMS has successfullypassed accreditation.

There is no web form option for Orthodontic payment submissions and prior approval requests, so if you do not currently use a PMS and submit claims on a regular basis, we would advise that you invest in a PMS capable of submitting orthodontic claims electronically.

Please note, youmay require one or more computers or laptops in your practice, for example, 1 per surgery, if that will fit better into your revised business processes. Your supplier may be able to assist in helping determine your technical needs.

1.2 My practice is a general practice but we submit orthodontic claims and prior approval requests

All general Electronic Data Interchange (EDI) accredited PMS suppliers continue to engage with us regarding the eDental changes. We have discussed Orthodontic electronic submissions with most and have now issued the eOrtho supplier specification for them to review. It is too early at this stage to advise whether all or any general PMS suppliers intend to make the changes until they have reviewed the specification. We suggest you confirm with your supplier whether they intend to undertake the work for eDental orthodontics.

If a general PMS supplier does decide to proceed with the development, then once the PMS has developed and tested their system internally, they must follow some additional steps before it is available for practices. Firstly, there is a dependency on each supplier successfully passing Fit for Purpose (FFP)testing thereafterundertaking a payment and approval accreditationprocess for orthodontics, prior to rollout. Electronic submissions for orthodontic activity cannot be submitted by practices until the PMS has successfullypassed accreditation.

When we receive confirmation of any general PMS supplier’s intention to develop their system, we will update this on our web site.

If a general PMS supplier chooses not to upgrade, then in order to submit orthodontic payments and approval requests, you may need to consider a move to a different general PMS supplier who intends to seek accreditation for orthodontic submissions or supplement your practice IT with an Orthodontic specialist PMS provider.

More information on this will be provided to you throughout 2018.

Over the next few months, we will publish information about those who intend to make the changes and seek accreditation on our web site at the link below. We will keep this updated regularly, so please keep checking the web site for the latest news update.

On a monthly basis, we will also provide an updated news article advising of progress:

The project team will continue to communicate to all dentists, in a variety of ways. We use the schedule communications each month as a prompt for you to look at the latest news on our web site and posted on As we move towards implementation, we will provide additional guidance.

If you require further information on this letter or its’ contents, please contact our helpdesk on 0131 275 6300 or via

Yours sincerely

Dave Tomsett

Chair of eDental payment and approval modernisation project board