“Helping practitioners move online benefits us all”

Nearly two years on from Primary Care Support England (PCSE) moving to an online system for General Ophthalmic Services (GOS) claims, 1.5% of submissions are still being made on paper – a percentage that might seem small, but equates to around 24,000 paper forms arriving in the post every month.

OT spoke with Salma Parveen, operations manager at PCSE, about the barriers to online submission, and what support there is available for practitioners who are yet to fully make the switch.

What is the current situation with paper claims, as you see it?

We moved online from February 2021. Statements are online, and you can view your claims, irrespective of submission channel, online. But we’re still seeing paper coming in. Last month, we had around 24,000 GOS claims submitted in paper. Overall, we get around one and a half million submission-wise, including online, every month. So, 1.5% is still a significant volume.

Since the beginning of 2022, we’ve seen the number of contractors submitting via paper reduce from around 220 or 230 to 180 or 190. Sometimes they’re using paper for some submissions, but for the rest they’re going online, so it’s not like they’re not using online submissions at all. You’ve got those who, because they use a practice management system (PMS) system, might be submitting GOS 1 forms online, but will do their GOS 3 and 4 forms through paper, so they haven’t transitioned fully. Because we haven’t said you can’t use paper as a submission channel, it’s still an option.

Do you know why some practitioners might still be submitting paper forms in some, but not all, cases?

We did callouts at the beginning of the year, especially for contactors that have high rejection rates. That’s the biggest concern area. If you’ve got high rejection volumes and paper is your only submission channel, you’re not getting paid for anything, and that causes queries and complaints. So, we did callouts with them, and the reasons were varied. Some said they were looking at a PMS system but weren’t sure.

Some of them use the PCSE Online system, but feel like it is too slow. We’ve made massive improvements over the years, but some contractors don’t like the flow of it. That was one piece of feedback. We can’t say much to that, because it flows in line with how the paper flows: you’ve got your patient details, your signature from the patient, your prescription, your signature from the performer, then your supplier, then your signature again to confirm you’ve collected it. It’s exactly the same flow as on paper. Some of the feedback we’ve had is that it takes too long; it’s not in line with how they want to work. But we can’t change the flow of how the system is, unfortunately, because it’s in line with the paper, which is mandated by NHS England.

Some practitioners don’t want to move from paper, even when they have received rejections. But paper can never be perfect from both ends. You might make errors when you’re filling it in, and if you’ve got little boxes that you’re writing rather than typing into, that might cause a rejection when the system reads it. So, it’s a two-way street.

For those who don’t know much about PMS providers, we try to provide details on what a PMS system is, and how you can use PCSE Online. The odd contractor has hinted at not knowing what PMS systems to use, but PCSE can’t recommend on that. We can advise going online and searching for a PMS system for ophthalmic services, but we can't recommend one from a PCSE perspective, because we don’t use them. It’s also about understanding the financial aspect of it – that a PMS system is not a very expensive investment.

If you’ve got high rejection volumes and paper is your only submission channel, you’re not getting paid for anything, and that causes queries and complaints

What is the value of submitting electronically for the practitioner?

With online submissions, it’s a securer and faster system. You’re going straight online; you’re not waiting for your paper claims to be posted and risking them being lost. There are also delays at the moment with postal strikes, and that causes problems. If you don’t reach the cut-off date, you’re not going to get paid in that month. When you’re submitting online, you’ve got an immediate response. You’re not waiting a week or two weeks for that claim to be processed and then accepted or rejected.

PCSE Online doesn’t generate rejections. It flags immediately that you cannot proceed, so you’re going to know straightaway that you’ve made a mistake. You’re not going to get a rejection at any point, so you know you’re doing everything correctly. It’s much faster. If you put in a claim tonight, you’re going to get a response tonight or tomorrow morning, rather than waiting.

It is a very secure service, where only you can access your account details. Nobody else is going to get your forms. They’re not going to go to the wrong place. You’re going to eliminate those risks. I think it’ll also save money on postage. But I think the biggest thing is the fact that you’ve got an immediate answer.

Is there any support that PCSE can offer practitioners who might be nervous about moving their claims entirely online?

We’ve got tools online, including YouTube videos. For those who are transitioning to paperless claims, we can talk it through from an ophthalmic perspective. If they say, ‘We need a screen-sharing session, we want to know how to do a GOS 1 or a GOS 3 claim,’ we will walk them through the process and show them what they need to do. We’re happy to invest that time, if they’re willing to invest a little bit of time with us. We are happy to go through it, as well as point in the direction of the website, where we've got PDF booklets that practitioners can use to guide them through the different screenshots and what they mean.
 
If anyone is struggling, if they're happy to book in a Teams call, we will screen-share and show them what to do. We can talk them through an example of a claim that they've put in and address any challenges they have. Helping practitioners move online benefits us all.

If someone does want to take you up on that offer, who should they contact?

They can email [email protected] to book in a session. I want to emphasise that this email address can only be used for that purpose, though – other queries will not be picked up via that channel. But to book in a walkthrough on how to use PCSE Online, they can contact us there.

Is there anything else you want to say to encourage practitioners to move online?

It would be useful to understand why some practitioners are not using the online system for all GOS types – what are the challenges they’re facing? Why are they only submitting GOS 1s online? Is it because they’ve got a PMS system, and think they can't use PCSE Online?

We’ve tried to flag those things to say, actually, you can. You don’t have to use paper. If you’ve got PMS system for one GOS type but not the others, you can still use PCSE Online for your other GOS types. That’s not an issue.

If they’re already online, it’s trying to understand why paper submissions might still be needed. If we can support with the forms they haven't moved online for, we’re happy to talk through those with them.

Some of the contractors who are using both paper and the online system are only submitting a couple of claims on paper, but others have larger volumes. It’s about trying to understand why they're doing that. If they’re having challenges with a specific GOS type, and it’s through PCSE Online, let us know. We’ll have a look at it and do those walkthroughs with them. For those that are using both submissions, you’re halfway there. If we can push you to the full extent to be 100% online, that's what we’d like to do.