NHAIS Finance Development News - NHS Connecting for Health

Issue 40 – April 2011• Bulk or Individual (or Both types) of claim submission.The FJ-FIND already allows users to specify a date range for inclusion of claim dates within thatrange.Additional data items requested for inclusion are:• Claim Description (from the EM Paycode Description)• Amount Paid• Bulk or Individual input (‘B’ or ‘I’)• Paid or Unpaid (‘P’ or ‘U’)• Payment Date (for claims paid since the introduction of this change).These augment existing data items available for selection on FI:• Number of Claims (Usually 1 for Individual Input)• NHS Number• Payment Rate• Claim Date.This change requires modifications in three areas. The significant visible change affects the FIDESE/CLAIMS screen which must now include additional items for Description, Amount,Bulk/Individual, Paid/Unpaid and the Payment Date. The revised FI screen is shown below:FI]Finance Download Qualifier[DESE/CLAIMS ]Directed or Local Enhanced Services Claims Details[Y] Paycode[N] PCT Code[Y] Practice Code[Y] Payment Rate[Y] Claim Date[N] NHS Number[Y] Number of Claims[Y] Claim Type (Bulk or Individual Input)[Y] Claim Payment Status (Paid or Unpaid)[Y] Payment Date[Y] Amount paid for claim[Y] Claim Paycode DescriptionFigure 19: Revised FI Screen for DESE/CLAIMSInclusion of Bulk or Individual Flag or Paid or Unpaid flag within the download allows theanalysis of the UNIX file to select and/or sort on these fields, supporting additional analysis ofclaims submitted. Amount paid is recorded for both paid and unpaid claims (with amount forunpaid being the anticipated payment at the appropriate EM rate).The requirement to include both Claim Date and Payment Date on the paid claims downloadrequires changes to FJ-DESE processing to write Paid Date to piece 2 of the ^EMHIST file,keyed by Bulk/Individ (B or I),Paycode,PCT,Practice,Rate Band,Claim Date,NHS Number. Thiswill only be present for those claims processed following introduction of this change; claimssubmitted prior to the change will default to Payment Date of ‘Unknown’. Payment Date forunpaid claims will be recorded as null.The inclusion of the additional fields on the data-driven FI screen is relatively straightforwardand is being accommodated by additional ^FIDET(“DESE”,”CLAIMS”) nodes. The additionalrequirement for further FJ-FIND processing to build the additional data items into thedownloaded UNIX file involves specific new coding. This work was completed last month and18 © Crown Copyright