PES Practice Invoices and Reconciliation

 This guide provides information on your PES invoices and reconciliation - what information is available on Opera and expected timescales for payment.  

We are continuously improving and developing this as we streamline the financial process to ensure greater visibility and more timely payments so please check this page regularly. 

Invoices

Activity completed by your practice for a particular service in a month will be compiled and an invoice generated in the second week after month-end. With the overarching invoice from Primary Eyecare Services (PES) and associated supporting data submitted to commissioners thereafter along with associated backing data that commissioners ask for. 

This process requires no action by practices as is carried out by PES with the support of Opera and other associated systems. 

Your practice invoice for the previous month will be available to view in Opera the second week of each month. Simply look under Accounting and Invoices (For April 2021 invoices onwards). You can view and download the invoices to your local system. We have, following feedback, added additional information to help you reconcile payments - this information can be found under Accounting and Reconciliation - see further information further along in this help guide. 

When you select 'Invoices' - all your invoices for the activity carried out through Opera will appear on the right-hand side of the screen. There will usually be one invoice per NHS Commissioner per month (for one or two areas invoices will be broken down by service). 

An example of what this looks like can be seen below: 

Information in the Invoice list provides various elements of information: 

  • Date: Date the invoice was generated 
  • Description: The month and commissioner that invoice relates to
  • Amount Due: Total invoice value 
  • Amount Paid: This will be populated with a figure when you have been paid. This should match the amount due in the vast majority of cases except where there has been a removal of an episode for one reason or another - i.e. duplicate patient episode. 
  • Status: 
    • DRAFT = Draft invoice pending authorisation by PES
    • AWAITING PAYMENT = Pending NHS Commissioner payment
    • PAID = The status will change to PAID when that invoice has been scheduled for payment. Practices will receive payment within 7days of the payment being marked PAID. 

PLEASE NOTE: The Account number and Bank account name we are using will be noted under account details. If this is not where payments should be made then please contact us via the Help function/Blue Bubble or email us at hello@referral.support. 

PLEASE NOTE: Older PES Opera invoices and information can be found under legacy with reconciliation data for these invoices found on pages 2 onwards of the invoice.  

Reconciliation

Your practice invoice reconciliation information is available on Opera. The detail for each patient activity invoiced can be found on the invoice itself with the OPR number and Initial noted on the invoice itself. 
Further information can be found under 'Accounting and Invoices' and select Reconciliation. You should select the Year, Month and CCG/Commissioner you are looking for the information relating to. 

You can download the reconciliation report to your local system by selecting the Downloads button.

Payment

£

The commissioner invoice is due for payment to PES 30 days after submission (approximately 6weeks after month-end) and disbursement to practices will take place within 2-3 working days to optical practices after PES has received the monies. This will be paid to the bank account you uploaded details for onto Opera as part of the onboarding process. 

Expedient payments to practices is one of Primary Eyecare’s core focuses, as we understand the impact of delayed payments can have on cash flow and businesses.  In Q4 2023, Primary Eyecare will be launching a new process that will see better communications to practices on delayed payments, as well as payments that are made. Critically, Primary Eyecare will be engaging more regularly with Commissioners to ensure payments are made more promptly and targeting problem areas with additional action and pressure. Through improved internal processes, more engagement both with practices and commissioners, that we should see invoices paid promptly on a regular basis.

PLEASE NOTE: An invoice becomes overdue for payment to PES approximately 6 weeks after month-end and to practices 8 weeks after month-end.

Note: Some independent sector providers payment terms and conditions are 60days post invoice and so the above timescales will be longer for these. 

It is expected that regular monthly payments should be made to practices albeit they will be for 1-2 months in arrears due to the above process with NHS commissioners. 

Inevitably there will be cases where some are delayed payments from commissioners and thus the above process is delayed and extended. Please note there are often some delays in the early stages of a new service prior to the regularisation of payments.  

In all cases, PES will actively chase commissioners for overdue monies and pay practices as promptly as possible.   

[Please Note: As per the subcontract that practices have with PES - payments can only be made to practices after PES has received monies from NHS commissioners. PES does not retain large reserves as it supports the sector by maximising fees paid to practices and as such we are dependent on timely payment from commissioners to ensure timely payment to practices]

If there is a specific overdue payment that you have concerns about please send your query through the blue bubble or email hello@referral.support along with a completed payment query escalation proforma available here

Missing Activity on Invoices

You must close/complete (and appear marked Green on Opera) an episode in order for it to be charged. If you need to close an open episode you can follow the instructional guide linked here to enable you to do so. If you need support when closing a patient episode, please contact us for support via the help function on Opera.

Please remember that episodes should be completed and closed on Opera ideally on the same day of the patient interaction took place (as a minimum for those being referred) but MUST be added within 2 working days as a minimum. This is important for patient safety, communications with GP, contractual requirements, etc. - including invoicing and payment!      

Patient episodes which are added on late which are older (e.g. 3mths previous) are unlikely to be invoiceable and thus may not be paid.  

Support / Queries 

Should you need general finance support please either go to app.optom-referrals.org and use the help bubble to raise a query or email hello@referral.support. 

Where adjustments are required these will be made to your next month's invoices for that commissioner. We expect there will be very few of these.

When raising queries please provide your practice name, ODS code, and OPR numbers for episodes that you need assistance with.   

Review date: 04/01/2023

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