NHS North East and North Cumbria Integrated Care Board (ICB) were first introduced to CQRS Local in late 2020 and were initially keen to trial the new system.
The ICB have a robust manual process when it comes to claims processing and reporting and were looking for a more efficient way to allow review of claims on screen.
“We have close links with the North of England Commissioning Support Unit team, and they advised us that a new local process would be replacing ClaimIT.”
Locally commissioned services
After staying in touch with the local developers, the ICB advised them of locally commissioned services they had running, to help facilitate the build of the CQRS Local system.
This early input from the ICB became one of the key elements of the system being built, with no limit to the number of locally commissioned schemes that can be managed.
“All of our locally commissioned services have been offered via CQRS Local for the first time this year. We intend to use the system for claims, monitoring and reporting as a commissioner.
“We commission a number of services with different KPI metrics which, historically we monitored manually on a quarterly basis. It was evident that the proposed system would automate a lot of this for us”
Overcoming issues prior to using CQRS Local
Prior to CQRS Local, the collection and collation of claims for locally commissioned services would take about two weeks.
“The circulation of claim forms, reminders, reviews of submissions, query management, service delivery review, management by lead commissioners, and finally the preparation of final documents for the panel payment authorisations were all very time consuming.
“But it is expected that the automated process will cut this time considerably. Reviewing claims in-system will reduce the manual processes involved in circulation of claim forms, reviews of submissions, and will identify anomalies more easily for the commissioner. It will also reduce queries from providers as they will be able to see the stage at which their claims are sat in the system autonomously.”
Benefits of CQRS Local v National
North East and North Cumbria ICB is yet to use the reporting tool on CQRS Local but have had input into the development of the system, around the reports which can be generated.
“We have better access as a commissioner for CQRS Local than the national system. The national system offers very basic reports and doesn’t seem as easy to interrogate for the split required. CQRS Local does appear to be very intuitive and logical to use whereas the national system does not.
“The reports generated will allow us to present more effectively the evidence for payment at the quarterly review panel and as the system calculates the values to be reimbursed, this will also support payments processing.”
Whilst the ICB has had a very robust manual process that has been in place for providers for a number of years, it is expected that this system will reduce queries from providers about the current status of claims and what remains to be claimed or missed.
“Providers will start to use the system for the first time in July 2022, but from a commissioning perspective, having all of the specifications, reporting and claims in one place and automated will streamline processes for audit and payment purposes.”