Terms and Conditions for Optometrists
1. Basis of recognition
Your relationship with OcuPlan is important to us and we agree to recognise you as an “OcuPlan Partner” on the Terms and Conditions set out in this agreement and (where relevant) on the basis of your online application form which forms a part of your agreement with us. In return, you agree that any agreements or arrangements you may have with a Member are subject to your agreement with us.
In order to register with OcuPlan you must have the following:
You also agree to notify us immediately of any:
Every 12 months we will ask you to re-confirm that your registration details and minimum requirements for providing OcuPlan services have not changed, and that you still agree to the Terms and Conditions set out in this document.
Under OcuPlan’s scheme rules, we will only reimburse you if you have an agreement in place for the provision of diagnostic tests for OcuPlan patients as long as they present you with a valid membership card. Charges to OcuPlan, or Members for diagnostic tests without a pre-authorisation, or any charges outside our contract with you, will not be paid and may lead to the loss of your OcuPlan recognition.
OcuPlan funding for diagnostic tests is only available for the ocular investigations listed in Schedule 1 of this agreement.
You acknowledge that you will comply with the service standards set out in Schedule 2 of this document.
You have signed during the online registration process to say you will abide by these Terms and Conditions.
You agree to our Privacy Notice on our website, and also agree to only send patient investigation results and reports directly to the Member’s Ophthalmology consultant or authorised administration team using an NHS.net email address, or an Egress password protected email system.
2. Clinical Standards
We trust that the clinical quality of the ocular investigations that you perform for our Members will be acceptable. In support of this, you agree to provide all diagnostic tests in accordance with the Clinical Standards published in our Terms and Conditions. We may on occasion receive a complaint that is clinical in nature. If we contact you about such a case, it will usually follow a complaint made to us by one of our Members. We wish to ensure that all our Members have received high quality medical care and treatment. We ask that you fully review any such complaint and, in line with the guidance set out by the General Optical Council, provide us information, to the extent permitted by applicable data protection legislation, which will help us to address any Member concerns.
3. Services
This section relates to the expectations of our Members in relation to the services provided, and we are asking you to sign up to the minimum as described below. You agree, where practically possible, to provide ocular investigations to Members within a maximum of 14 working days from request by the Member, and you agree to ensure that diagnostic tests are completed and reported in a timely manner. You agree to ensure that someone can be contacted to arrange appointments for you within the normal working hours of 9 AM to 5.30 PM and to ensure that an ‘out of hours’ answer phone service is provided for Members calling at a time when no one is available to take appointment calls in person. You further agree that Members leaving a message on this service will receive a call back within 48 hours Monday to Friday.
After performing the ocular investigations, you agree to email the results using a secure NHS.net account, or Egress password protected email to the Member’s ophthalmologist directly or to their authorised administration team.
4. Charging Members
Charging Members personally unexpected bills are a major cause of customer complaint and so we have set out below how charging needs to operate. It is a condition of this agreement that you will not invoice or bill Members personally for any ocular investigations included in their OcuPlan package. The OcuPlan scheme does not include any optometry consultation fees for additional work such as slit lamp examination, fundoscopy, refraction, prescribing or fitting of glasses or contact lenses; these activities are deemed outside the scope of your contract with OcuPlan and also not included in the patients OcuPlan package. Patients are not allowed to be charged a consultation fee by you if they are attending your practice solely on that day for ocular investigations. However, you are not bound by this term if the patient voluntarily wishes to purchase other services from you. We ask however, that you make it clear to Members that you are not charging them any additional personal costs in relation to the ocular investigations you have performed for us as part of their OcuPlan package. An example of this would be if a patient attends for their eye test with you, then this would be billed in the traditional way by your practice, and if they can still have a set of OcuPlan investigations at the same time, which would be paid for via OcuPlan.
5. Charges
We will only pay for pre-authorised ocular investigations set out in Schedule 1 to this agreement. Fees are all inclusive (including VAT) and represent full payment from us to you. The charges in relation to ocular investigations are set out below in Schedule 1.
6. Invoicing
It is not necessary to submit an invoice to receive payment for OcuPlan investigations because the payment process is automatically triggered by scanning a valid OcuPlan membership card. The QR code on the membership card can be scanned using a smart phone or tablet device logged in to your OcuPlan account. Scanning the Member’s OcuPlan membership card will automatically connect with their account, register and authorise the visit, and start the payment process to you. There is a kiosk function that can be found on the OcuPlan website that is a useful tool for the reception area and administration team, so they are able to scan membership cards when patients arrive to your practice. Scanning the QR code using the kiosk function also automatically starts the payment processes to you and registers the patient on your OcuPlan account. If a Member does not have a valid membership card, then you will not be paid for the investigations unless you call us to try and remedy the situation promptly within a few weeks. If the Member requires additional investigations and they have already used up their OcuPlan entitlements for the year, then they have the choice of purchasing these form you in the traditional way.
We advise that you keep a minimum data record of consultations for OcuPlan patients to consist of the Member’s name, date of birth, and date of consultation as this information may be required for internal audit processes or if any payment discrepancies arise.
7. Payment for services
Payment to the optometrist from OcuPlan will only be authorised if the Member presents a valid OcuPlan membership card with a QR code that needs to be scanned on the day of the investigation. If the patient forgets their membership card you can call us on the day or shortly afterwards to authorise the payment over the phone. Please try and do this as soon as possible.
OcuPlan will pay directly into the bank account provided by the optometrist within 3 months of the set of investigations being performed.
In the unlikely event that you perform a set of investigations on a Member who is paying by instalments, and then shortly afterwards they cancel their OcuPlan membership before completing their full payment cycle, then OcuPlan will seek to recover any outstanding monies owed by the Member and pass any payments owed on to you within 90 days of the first missed instalment.
Occasionally we may overpay an invoice in error. Where you are overpaid, we will ask for this to be refunded to us if required. We will occasionally conduct an audit of your underlying payment procedures and history to confirm compliance with these terms. You must agree to assist us on any reasonable request in these audit activities.
8. Ending Your Agreement
This section of the document addresses the processes and rights where either you or OcuPlan may end this agreement at any time by notifying the other party in writing on 30 days’ notice. Notification from you to us to request to end the agreement should be sent to OcuPlan Limited, Kingsway House, 40 Foregate Street, Worcester, WR1 1EE. You may also end this agreement through your OcuPlan account, in the settings section.
Where we feel that there are issues of safety regarding the performance of ocular investigations of Members, or indications of fraud, we may end this agreement and/or your OcuPlan Recognition immediately on the provision of notice or suspend it or apply additional conditions if we feel that this is appropriate.
We do expect that in return for the support of your practise and referrals to our Members, you maintain a professional relationship with our Members and do not disparage OcuPlan. If a Member is receiving an ocular investigation on the date your recognition ends or is suspended, you will have to inform the Member that you are no longer in the OcuPlan scheme. At that time, you can either ask the patient to authorise you to bill them for the investigation, or direct them back to OcuPlan’s help desk, where we will direct them to another OcuPlan approved optometrist for their investigations.
9. Insurance
It is essential that you hold professional medical indemnity insurance to protect our Members and that this is from a recognised UK organisation and covers at least a minimum of £5 million UK pounds per claim.
It is important that you care for our Members in the same way you would care for private patients normally.
The medico legal responsibility for monitoring, the frequency of consultations and investigations, and interpretation of investigations rests with the consultant ophthalmologist for whom the patient is under their care, not with the optometrist.
10. Data protection
You must comply with Data Protection Law and the Data Protection Act 2018. Situations may arise where we ask you to disclose Member Data to allow us to effectively provide our Members the services they are entitled to. If you feel that sharing this information is in breach of Data Protection Law, then please notify us via email.
We advise that you familiarise yourself with our Privacy Policy, which is available on our website.
11. Anti-bribery and corruption
You agree to comply with all applicable laws relating to the detection and prevention of financial crime.
12. Disputes
Rarely dispute between us and you may occur, if this happens it is important you let us know your concerns at the soonest possible time and give us a call so we can try and solve the problem quickly over the phone. If you are not satisfied with the response you can put your complaint in writing, and we will arrange an opportunity to sit down together and talk through the dispute. Written complaints regarding a dispute should be sent to OcuPlan Limited, Kingsway House, 40 Foregate Street, Worcester, WR1 1EE. Sometimes the dispute can be resolved in writing and where possible we will try to do this promptly within 30 days.
OcuPlan operates under the legal framework provided by the Consumer Rights Act 2015. Under the terms of this Act, if services are provided in a way that is deemed to be inadequate or falling short of the standards set out in this Terms and Conditions document, then OcuPlan has the right to ask you to repeat these for our Member free of charge to address these shortcomings. If services have been performed and you have been reimbursed by OcuPlan for these services, and they are then deemed to have fallen short of the standards set out in the Terms and Conditions, or by the standards deemed fair and sensible by either the Member involved or OcuPlan, then OcuPlan has the right to either ask for a refund from yourself of the total amount paid, or a proportion of this amount deemed to be fair.
13. General
Please note that these terms are governed by English law and represent the whole and only agreement between us relating to the subject matter of these terms.
14. Definitions
Schedule 1
The below set of investigations is included as part of this agreement:
• A set of OcuPlan investigations, considered to be a full-threshold 24-2 visual field test and an Optical Coherence Tomography (OCT) scan of the retina and optic nerve glaucoma OCT scan.
As independent optometry practices you are flexible to choose your own OcuPlan fees for providing a set of OcuPlan investigations. We have standard OcuPlan optometry fees that are chosen to be socially aware and make private eye care more affordable for patients. The standard fees also provide patients with simplicity, clarity and predictability about the likely price of their chosen OcuPlan care package.
Our standard OcuPlan fee for a set of OcuPlan investigations is £50.00.
If you choose to set your OcuPlan fees higher, this will make your patient's OcuPlan care packages more expensive and less affordable. Similarly, if you set your fees lower, this will make your patient's OcuPlan care packages less expensive and more affordable. When you decide how to set your OcuPlan fees, it is important to do this in confidence from your competing peers. You can change your OcuPlan fees at any time and can do this by giving us a call. We keep this information confidential and do not share it with other professionals in line with our competition compliance policy and data protection policy.
The fees we pay you for patient investigations will be determined by the fee registered to your account at the time the patient initially purchased their OcuPlan care package, or at the start of their renewal year. This means if you change your fees during the year, the patient will be quoted a new package price based on this change when they come to renew.
The OcuPlan package prices for patients are calculated by adding together your optometry fees for providing OcuPlan investigations, either the new or follow-up consultant consultation fees as relevant, and our administration fees for providing this service.
Schedule 2
Ocular investigations should be performed in a safe and appropriate clinical setting that reflects the standards that OcuPlan would expect of all of its providers.
You agree to:
(a) provide to Members a set of OcuPlan investigations in a safe and professional manner;
(b) comply with all necessary legal and regulatory requirements of your profession, including if relevant to provide investigations in a site approved by the Care Quality Commission;
(c) stop performing OcuPlan investigations if they cannot be provided safe way and inform immediately in writing about this;
(d) have an infection control policy and procedure that is up to date and have undergone appropriate mandatory training and provided appropriate training to you staff;
(e) have a process for the investigation of adverse incidents and/or complaints;
(f) ensure that each health care professional employed by you to perform OcuPlan investigations has the correct qualifications, skills and experience and is registered with the relevant professional body.