NES Based Capitation Funding for 1st April 2019

Preparation before April 1st 2019

Adds Capitation scheme for all patients enrolled after last register upload to PHO (Nov 2018) if they are currently E-Enrolled

(Register upload in March will not be used to determine Capitation patients for April 2019, it is only for PHO analysis.)

From the Tools menu, select Downloads, then Update Capitation based on E-Enrolment

(The ability to Upload a CBF File from your PHO to update Capitation is no longer needed and has been removed from the menu)

How Funding will now be determined and displayed

Funded patients will have a current Capitation Scheme (Unchanged)

Whenever E-Enrolment is added or updated at the National Enrolment Service, a Capitation scheme will be changed accordingly.

  • Capitation funding will start on the 1st day of the month following successful e-enrolment
  • Capitation will finish on the last day of the month when e-enrollment is ended
  • If e-enrollment is extended (e.g. the enrollment date is changed), the Capitation expiry date will be changed to match the new expiry date of e-enrollment.

Schemes with a start date in the future will have a grey colour

(There may be a current Capitation scheme and a future one in March 2019, then only one after April)

Reports

To find patients that may be eligible but have not been e-enrolled

  • Regular
  • NHI Number
  • Eligible for Public Funds
  • Signed enrollment form – Enrolment Date Present
  • No e-enrolment

This report may be useful in finding patients not seen since e-enrollment started but still want to use your services as their usual General Practice. You can manually update their schemes in the Patients Detail Screen. If they have not enrolled elsewhere you will see E-Enrollment and Capitation in their scheme list.

Facility and Practitioner Identity Synchronisation

When the preferred practitioner or Preferred Facility is updated in the Patients Details screen – NES is updated.

If need to change the Preferred Practitioner for all Patients belonging to a departing practitioner: Tools Menu, Clean Up, Change Preferred Practitioner.

Changes for all the patients will be sent to the NES. This may cause capacity issues because of the large number of messages.

  • Please restrict use this function to off peak hours (after 7pm and before 6am)
  • Select the departing practitioner and the incoming practitioner
  • Click on Procced

This function can also be used if a practitioner needs to change his/her CPN (Rare!). Select the same Practitioner in both lists.

A corresponding function is available for changing Facility Ids

CPI Extract change.

These extracts will now contain the enrolment Id of each patient. There is no change in the process for sending these files.