Care Management Platform (CMP)
CMP Weekly Release (UK Edition)
Build 0.0.0.4094 | October 9th, 2019
Part Two of the highlights of the changes available in this week’s Care Management Platform (CMP) release. It should be noted that these updates are specifically for those customers using CMP in the UK.
Once the patient’s NHS course of treatment is accepted, the provider can begin completing treatment items. Course acceptance is handled via the “checkmark” icon next to the Treatment Plan name in the Hard Tissue Chart UI (Planning mode) or the Treatment Plan UI. Note that this will also reject any other open NHS courses of treatment, as you can only have a single accepted NHS course. Once the NHS course of treatment is accepted, the NHS claim is automatically created and available.
Once the NHS course of treatment has been accepted, then users can start performing and completing the work. If the patient fails to start the NHS course and none of the treatment has been completed, then the provider can “Delete Plan and Claim” via the Treatment Plan information popover (hover on “i” icon wherever the Treatment Plan is displayed). This will delete the NHS course of treatment and the provisional claim. If the patient started the NHS course of treatment, but failed to complete the entire course, then the provider can “Mark as Failed to Return” via the Treatment Plan information popover. CMP will then provide the user with options on how to handle the unfinished treatment items in the NHS course. The provider can then move any uncompleted items into a new, open NHS course of treatment or discard them entirely. In either case, the user can now manage the NHS claim for the treatment that was completed and claim the associated UDAs. If the patient has completed the entire NHS course of treatment, then the provider can mark the NHS course as “ready to send” to prepare the claim for submission.
Once the entire course is completed (or marked as “Failed to Return”), the provider can mark the NHS course as “Ready to Send” via the “Update NHS Claim” UI. From this UI, the user can review and update as much of the claim information as needed. Most of the claim information is automatically pre-populated from the information already provided by the preceding user actions, but the user has the option to override these calculated values. This includes the Charge Band and Activity Band determined from the NHS procedure rules and the collection of procedures completed in the course of treatment, as well as the Exemption status (which had been defined in the Patient Record), the Clinical Data Set / DMF information (which was again determined by the set of completed procedures from the course), and other service information. The provider also has the option to mark the delivery of NICE guidance and set the patient’s recall interval and also enter the patient’s email address or mobile phone number to be contacted for surveys about their NHS dentistry experience.
CMP will automatically deal with exception cases, saving the user additional confirmation work and preventing mistakes. For example, if the patient has recently had a completed NHS course of treatment within the last two months (of the same or lower UDA banding), then this new course (and claim) will not have an associated patient charge and the associated claim will automatically be marked as a “continuation of treatment”.
Once the user has defined the NHS claim details to his or her liking - or has simply accepted all of the pre-populated defaults - the claim can be marked as “ready to send”. Clicking on the “Mark as Ready to Send” hyperlink in the Update NHS Claim UI will trigger CMP to automatically perform a series of validation checks against the claim data that are known that result in claim rejection. If any validation errors are found, then the user is notified and prompted to correct these issues before the claim can be set as “ready to send”.
Once any validation errors with the NHS claim data are addressed, the claim is set as “Ready to Send”, and it is available for transmission. NHS claims can be reviewed and managed via the Claims Management UI, available at both the practice (location) level (Location Tab → NHS Claims → Claims Management) and the individual patient level (Patient Tab → NHS Claims). In the Claims Management UI, users can review and manage existing claims, filter existing claims based on claim status and associated provider (e.g., claiming dentist), and send/receive NHS claims. For example, users can filter the claims list to only see those claims that have been rejected or adjusted, so that they can correct and re-transmit these claims. The “Recently Settled Claims” UI is also available to review NHS claims that have been paid in the last two months (Location Tab → NHS Claims → Recently Settled Claims).
To transmit the “Ready to Send” claims, the user must simply click on the “Send/Receive Claims” action in the side panel of the Claims Management UI. From here, the all providers associated with “Ready to Send” claims can log in with their PIN (Personal Identification Number) and send all applicable claims. Any NHS claims that are “Ready to Send” and are associated with a provider that has entered his or her PIN will be transmitted. Note that any new performers have a chance to set their PIN and any existing performers have a chance to change / update their PIN from the “Send/Receive NHS Claims” dialog.
Note that this sending (transmission) process will also trigger the receiving of any NHS claim responses. Practices can receive NHS claim updates daily, as CMP receives and processes the DAILY schedules from the BSA. To take advantage of this daily reporting, the practice does need to opt in to receive DAILY schedules on the Compass portal. CMP also automatically processes monthly schedules when received. Claim statuses are automatically updated based on BSA responses received.
All changes in NHS claim status are recorded and the history is available for review. The claim status history is available by clicking on the “View History” hyperlink in the NHS Claim UI. This history provides the user with a clear audit trail of the claim’s journey through the process.
Finally, if the claim is rejected or adjusted, the user can view the Claim History on what has happened. If the claim has been adjusted, users can “View History” from the Update NHS Claim UI to review the nature of the adjustment. From here, the user can elect to settle the claim (e.g., “Make Settled”) to accept the adjustments or can create a new submission and make any necessary changes before re-submission. If rejected, the user can use the Update NHS Claim UI to create a new submission, make any changes, and then resubmit the claim. Additionally, in either case, the user could elect to simply delete the claim entirely (and potentially start over with a new claim process). Once finally accepted or otherwise settled, the claim status will be updated, moved to the “Settled Claims” list, and the contract target reporting (UDAs) will be automatically updated if the UDA value has changed from the original value.
We are very excited to be able to provide this functionality to our UK customers and look forward to hearing feedback on how this release supports the delivery of NHS-based patient care. This release should go a long way to support the core needs of many UK-based practices, enabling the management of NHS courses of treatment, including the ability to define NHS-based courses of treatment, correctly calculate charges, and create, transmit, and manage associated claims.
Medical History Questionnaires v1
This week’s release includes an initial implementation of medical history questionnaires, available to our UK customers. This allows the practice to record important medical information from patients, helping to ensure that everyone is aware of conditions and/or patient history that may affect treatment decisions. Medical history can be collected for both NHS and private patients.
The medical history questionnaires are available via the new Medical Questionnaires UI, which is now available in the patient’s tab (Patient Tab → Medical). Here, the user can review the latest medical history collected from the patient (by default), along with any other previous histories that have been recorded. Users can click “Complete New Questionnaire” in the side panel to record a new medical history for the patient directly via CMP during a patient visit or exam. Alternately, users can download a blank copy of the questionnaire (.PDF), pre-printed with the patient’s name, to print or otherwise distribute to the patient for manual completion. This physical copy of the medical history could then be entered into the Medical Questionnaire UI by users at a more convenient time and/or scanned and uploaded into the patient’s files (Patient Tab → Patient Files).
Currently, the medical history questionnaire is a simple set of yes / no questions, with the ability to add notes to provide any additional patient history that isn’t covered by the questions or otherwise needs clarification. Once saved, the completed questionnaire is available for review. As previously mentioned, all existing medical histories collected for the patient are available for review via the Medical Questionnaires UI, in case changes in patient history needs to be confirmed.
When an answer to a question is set to ‘yes’ a corresponding medical alert is automatically set on a patient to ensure there is a clear indication of the condition on the patient's record. If the user feels that a medical alert is not warranted then this can be removed from the patient's record manually.
We are happy to provide this clinical workflow support to our CMP UK customers and look forward to hearing how it assists with patient care. The functionality will be enhanced based on customer feedback, with possible future improvements including the ability to define custom questions and direct sending of the .PDF version of the blank questionnaire to a patient’s known email address (for offline completion). Carestream Dental are also currently working on a new version of the eForms service, which will significantly advance support for workflow involving electronic forms.
This week’s release also includes the ability for users to perform a postcode-based address lookup, allowing users to more quickly find and enter addresses. Once the user enters a postcode, the list of addresses associated with the postcode are displayed. Once selected, the street address, city, and county (and postcode) are all automatically populated. This workflow efficiency will help users ensure that addresses are both more quickly and accurately entered.
Patient Schemes v1
This week’s release also includes an initial implementation of Patient Schemes, available to our UK customers. This allows the practice to create custom patient schemes to assign to patients. Currently, this functionality will only be used to help identify patients of different types (schemes) more easily, but will have many useful applications as the functionality is extended. Users can create patient schemes via the new Scheme Settings UI (Administration Tab → Patient Schemes), where new schemes can be created and existing schemes can be managed. The user must simply define a name for the scheme and an associated type for the scheme. There are three preset scheme types - Private, Denplan, and NHS. It should be noted that new NHS-type schemes cannot be created (e.g., users cannot assign the NHS type to a newly created scheme).
Users can assign a scheme to a patient via the new “Patient Type” controls in the Patient Record UI (Patient Tab → Patient Record). The relevant patient type (scheme) can be selected and applied to the patient. As a result, a visual flag will be placed on the patient’s Patient Minicard UI, depicting his or her (general) scheme membership. This includes a green “PRV” flag for private scheme patient, blue “NHS” flag for NHS scheme patients, or black “DEN” flag for Denplan scheme patients. By default, patients set as the NHS scheme (previously discussed) will automatically be flagged as “NHS” (please note a patient cannot be a member of multiple schemes). Every patient will be automatically assigned to a scheme based on the patient’s association with a default location and that default location’s general status. For example, patients associated with NHS locations will automatically be assigned to the NHS scheme (same for private-only locations). Users can reassign a patient’s scheme at any time via the Patient Record UI.
We are happy to provide this patient administration workflow support to our CMP UK customers. The patient schemes functionality will be enhanced based on customer feedback, with possible future improvements including the ability to define multiple fee schedules and/or procedure lists that can then be associated with specific patient schemes, as well as scheme-based reporting.
Optimizations and Fixes
The following fixes and optimizations have been added to CMP this week.