Transcript Document
PRACTICE PAYMENTS FROM CCG Claire Fuller January 2015 What CCGs pay • Locally Commissioned Services – Quarterly as per contract • Other Payments Payment Processes vary between CCGs – use of SBS, CSU etc LOCALLY COMMISSIONED SERVICES NW GW Name of scheme LHRHa X X Drug Monitoring X CCGs SD SH East X X X X X X X X X X X X X X X X X X X X X X X X INR X X X X X Phlebotomy X X X X X Diabetes X X X X X 24hr BP Monitoring X X X X X X X Minor Surgery Minor Surgery Minor Surgery Minor Surgery - Section - Section - Section - Section A B C D Denosumab Injections Prescribing Shared Decision Making X X Care Home - Initial Assessment X Care Home - Six monthly review X IBD / Monitoring Toxic Drugs X Dementia Screening X Multi-Disciplinary System X Commissioning and Engagement X Practice Actions NWS G&W East Surrey Surrey Heath Surrey Downs Complete 1 spreadsheet Submit LCS claim form to Submit LCS claim form to Submit LCS claim form to CCG Submit invoice to SBS CCG by the specified CSU within 10 working to receive within 2 wks of then 3 actions quarterly date. days of quarter end quarter end 4 dates per year (as contract) Submit backing data to CCG Information Team Submit Dementia & Care 4 dates per year (as contract) a) submit hard copy invoice to SBS to receive Home claim forms to CCG by 10th working day of MH Lead (specified dates) the month after quarter end email address: [email protected] b) email copy of template to CSU ([email protected]) who validate c) delete NHS numbers and email copy of spreadsheet to CCG Submit a signed hard copy as an invoice to CCG 1415Q3H81002 Locally Commissioned Services Quarterly Data Collection Practice Name: Practice H Code: Locality/ Borough Quarter to which claims relate: List Size @ 31st March 2014 Quarter 3 - 2014/15 Claim Quarterly Rate (£) Amount (£) Detailed Activity needed Name of scheme Basis of Claim LHRHa (including Zoladex) per Injection administered 1 or 3 monthly LHRHa Domicillary Visit Drug Monitoring (formerly Rheumatology) per Domicillary Visit per Patient Monitored & on Register per quarter £ £ £ - Minor Surgery - Section A per Procedure £ - Minor Surgery - Section B per Procedure £ - Minor Surgery - Section C per Procedure £ Minor Surgery - Section D per Procedure £ Doppler per Patient per Examination £ INR - Lab Test 1 (Initiation)- no new sign up in 14-15 INR - Lab Test 2 (Maintenance)- no new sign up in 14-15 INR - GP Practice Full Service - Initiation INR - GP Practice Full Service - Maintenance INR - GP Surrey Pathology Full Service - Initiation INR - GP Surrey Pathology Full Service - Maintenance INR Domiciliary Visit Phlebotomy Pre Diabetes Register Diabetes Interim Check known diabetes Diabetes Initiation per Patient per Patient per Patient per Patient per Patient per Patient per Visit per Patient per Patient per Patient per Patient - AQP: Name of scheme Basis of Claim £ £ £ £ £ £ £ £ £ £ £ Amount (£) No No No No No No No No No No No Activity needed 24hr BP Monitoring per Patient £ - No TOTAL INVOICE VALUE per quarter for 6 months (2 claims) Monitored & on Register per quarter per quarter for 6 months (2 claims) Monitored & on Register per quarter per quarter for 6 months (2 claims) Monitored & on Register per quarter Attendance per annum per annum per Quarter for first year Claim Quarterly Rate (£) £ No No No Yes - see below for both activity performed in the practice and Virgin - subcontracted activity - - LCS - Local Commissioned Services - Quarterly Data Return / Invoice Back-Up 0 Practice H Code: 0 Practice Name: Raw List Size @ 1st April 2014 0 Weighted List Size 0 2014/15 Quarter for which claims represent: Name of LCS Scheme Basis of Claim Phlebotomy Per blood sample Claim £ - Zoladex Injections - (Quarterly Fee per pt) Per patient on register £ - Rheumatology Drug Monitoring - Level 1 Per patient, per Quarter £ - Rheumatology Drug Monitoring - Level 2 Per patient, per Quarter £ - Rheumatology Drug Monitoring - Level 3 Per patient, per Quarter £ - Rheumatology Drug Monitoring - Additional Per patient visit £ - 24hr BP Monitoring Per procedure £ - Buddy Service - 24hr BP Monitoring Per procedure £ - Minor Surgery - Section A Per procedure £ - Minor Surgery - Section B Per procedure £ - Minor Surgery - Section C Per procedure £ - Minor Surgery - Section D Per procedure £ - Buddy Service - Minor Surgery - Section D Per procedure £ - INR - Lab Test 1 Quarterly fee per Patient £ - INR - Lab Test 2 Quarterly fee per Patient £ - INR - NPT 1 Quarterly fee per Patient £ - INR - NPT 2 Quarterly fee per Patient £ - INR Domiciliary Visit Per visit £ - Diabetes Tier 1 Per patient after each completed health check £ - Care Home - Initial Assessment Per patient assessed in accordance with quality criteria £ - Care Home - Six monthly review IBD / Monitoring Toxic Drugs - Patients monitored on dual therapy Per patient reviewed £ - Per patient per Quarter £ - Multi-Disciplinary System Per quarterly schedule - Annual charge per patient £ - Commissioning and Engagement Per quarterly schedule - Annual charge per patient £ - TOTAL INVOICE VALUE TOTAL INVOICE VALUE 2014/15 0 Quarterly Rate £ Amount £ £ - 7 8 Primary Care Standards Quarterly Data Collection Practice Name: PMS/GMS Practice H Code: Quarter for which claims represent: List Size @ 1st April 2014 Name of scheme Basis of Claim LHRH Analogues Injections - (Quarterly Fee per pt not per injection) Per patient on register 0 Shared Care Drugs Monitoring Per patient, per Quarter 0 Drug Monitoring - Housebound patients domicilary visit Per patient visit 0 24hr BP Monitoring Per procedure 0 Minor Surgery - Section A Per procedure 0 Minor Surgery - Section B Per procedure 0 Minor Surgery - Section C Per procedure 0 INR - NPT 1 Quarterly fee per Patient 0 INR- NPT 2 Quarterly fee per Patient 0 INR Domiciliary Visit Per visit 0 Phlebotomy Per blood sample 0 Denosumab Per patient, per Quarter 0 Prescribing Name of scheme £0.50 Per registered patient on list size as at 1/4/14. Claimed only in Q4. Basis of Claim Quarterly Rate (£) Activity Max per year per pt. Total 0 Per Review/Initiation (£) Activity Max per year Comments per pt. Level 1- Type 2 diabetes on dietary/oral therapy Payment per review consultation (up to a maximum of 2 reviews per annum) £0.00 Level 2- Type 2 diabetes on insulin or GLP-1 therapy Payment per review for patient (up to a maximum of 2 reviews per annum) £0.00 Level 3- Type 1 diabetes Payment per review for patient with Type 1 diabetes (up to a maximum 2 reviews per annum) £0.00 Level 4- Insulin/GLP-1 initiation Payment per insulin/GLP-1 initiation £0.00 TOTAL INVOICE VALUE 0 Enhanced Services Quarterly Activity Return 2014/15 Practice Name: Practice J / H Code: Quarter being claimed: Raw list Size @ 01/04/2014 Name of Service Basis of payment Unit price (£) Total activity for quarter Payment due (£) Notes / activity report required INR - Lab test 1 Per patient per quarter See payment guide INR - Lab test 2 Per patient per quarter See payment guide INR - NPT 1 Per patient per quarter See payment guide INR - NPT 2 Per patient per quarter See payment guide Shared Care Drug monitoring Per patient per quarter See payment guide / Drug monitoring tab Diabetes care Per patient per quarter See payment guide Diabetes Per patient (one off payment @ initiation) See payment guide 24 Hour BPM Per procedure completed in quarter See payment guide Zoladex Per Patient per quarter See payment guide Shared Decision Making Per completion of PDA Activity See payment guide Minor Surgery Group A Per procedure Minor Surgery Group B Per injection Minor Surgery Group C Per procedure See payment guide / Minor Surgery tabs Minor Surgery Group D Per procedure See payment guide / Minor Surgery tabs Phlebotomy Per patient per venepuncture - insulin injection See payment guide / Minor Surgery tabs See payment guide / Minor Surgery tabs See payment guide Totals £0.00 Other Payments - Examples • Governing Body representation • Locality Meeting attendance • Clinical Leadership - agreed workstreams/projects • Incentive Schemes eg. Prescribing; frailty • Quality premium Protected Learning Sessions To ensure prompt payment • Prompt invoices • Unique invoice number • As per invoice template • Full description of attendance - hours, which meetings etc • Inform CCG/CSU - Change of Practice Name • Inform CCG/CSU- Change of practice Bank Account details Contacts NWS G&W East Surrey Linda Broughton Kathleen Andrews Steve Trigg Finance Manager, NWS CCG Primary Care Liaison Manager G&W CCG [email protected] Engagement Manager (Interim) East Surrey CCG [email protected] Nikki Mallinder Head of Locality Development [email protected] Sue Robertson Head of Locality Commissioning & Partnerships [email protected] [email protected] Contacts Surrey Heath Surrey Downs Locally Commissioned Services Lillian Nigrelli Emma Lang (Contracts Manager, South CSU) Senior Contract Manager, SD CCG [email protected] [email protected] Caroline Lovis (Finance Manager, CCG) [email protected] Julie Brooks, Finance Manager, SD CCG [email protected] Dementia Screening & Care Home Reviews Christy Tilney (MH lead, CCG) Martina Paton (Management Accountant, CCG) [email protected] [email protected] Questions ?