Presentation on theme: "The complete solution to managing real budgets and SUS validation."— Presentation transcript:
The complete solution to managing real budgets and SUS validation
The Activity Report is generated from the feed supplied from the Clinical System.
Here you can see the areas where iQ Budget Manager has been able to programmatically deduce the fields required from the information Summarised in the Practices Clinical System.
Here you can see the areas where iQ Budget Manager has not been able to programmatically deduce the fields required, this could be for a number of reasons, for example a poorly coded clinic letter or the information is not recorded locally…
The user has the choice to complete the record by referring back to the scanned letter, and completing the required fields. Required fields can be determined locally, Red meaning required, Orange meaning desirable.
iQ Budget Manager deduces charge codes by mapping Read Codes (v2or3) through to ICD and OPCS codes to suggest relevant Clinic Codes and HRG Codes. Where there is only one suggested code, the “For” field is automatically completed and highlighted in Green
Here you can see the areas where iQ Budget Manager has not been able to programmatically deduce the exact HRG Code….
….however, iQ Budget Manager will present suggested codes for the user to select from. The list is ranked by likelihood with the most likely at the top.
If multiple codes are suggested you have the option to select a group of codes, rather than a specific HRG Code. Multiple codes would then reside in the system for subsequent validation.
Better quality Summarising results in a faster and more accurate validation, leading to better Quality and Patient Safe Data
Because data is processed daily by the Practice and stored within iQ Budget Manager, when the SUS data arrives it is imported and compared instantly to the appropriate months activity. This is the only way to validate to ensure the Practice can meet the Reconciliation Point in time. Discharge Summary received by Practice Scanned in to Clinical System Record Sent to iQ Budget Manager and saved ready for future validation. Inclusion date Reconciliation point SUS Data Imported in to iQ Budget Manager and the validation process can start Queries Sent to Provider Day 1Day 2Day 3 Day 55 Day 56 Day 61 Day 62 Validation Process
Here we can see a summary of a statement that’s been imported. In this sample report, 95 SUS records have been imported, the application has linked and accepted as many as possible automatically. Leaving only the exceptions to review, this means that validating is achievable within the Inclusion date and Reconciliation point.
Records where no documentation has been received can be rejected by the user.
The user enters a preset reason as to why the item has been rejected.
Some items will require manually linking, in this example, the practice has entered a Follow-up Attendance, but the Provider has charged for a New Out-Patient Attendance
iQ Budget Manager, also automatically accepts records where both the SUS and Practice records match, and only presents the user with exceptions, the user can choose to accept the difference or raise a query.
If the user chooses to query an item, a preset list of reasons will appear, this enables queries to be sent to the Provider in a uniform manner.
The result are reports containing items that require further investigation with the Provider.
Extensive Reporting Functionality iQ Budget Manager not only validates provider charges, but also ensures other local and national targets can be met and monitored. It automatically generates the following reports Monitors Referral Patterns Monitors the Quality of Discharge Summaries Monitors Referral Sources Monitors Discharge Medications Monitors Contractual Arrangements with Commissioned Providers Monitors CQUIN & QIPP Targets Monitors Budgetary Spend (Top Line and Detailed) Monitors the Timeliness of Clinic Letters and Discharges Monitors Local & National Tariffs Monitors Re-admissions within 30 Days This list is not exhaustive and many custom reports have been produced by working locally with each PCT/PBC Consortia/Localities Monitors Excess Bed Days