The Ardens CQRS searches have been designed to support GP practices with optimising CQRS payments by addressing any potential coding errors which may affect payment. This will ensure the payment extracts via GPES are as accurate as possible. For a further understanding of how the CQRS payment system works, please see this support article.


It is important to understand that Ardens CANNOT 100% replicate the business rules as some parts are not replicable within the restrictions of EMIS Web reporting. The searches provided are written as closely to the published rules as possible and GP practices need to take this into account when submitting claims. 


To access the searches, navigate to Population Reporting > Ardens Searches > 5.40 Contracts - CQRS 2022-25.



Managing CQRS Data

We strongly recommend watching the following webinar for further guidance on how to use the search suite to manage data.


To fully optimise the use of the Ardens CQRS search suite, we suggest running the searches in the following order.


Step 1 - Run the "ACTION  - Data quality checks"

These reports are to be run on the 1st of each month to correct any potential payment issues before the extraction process.



The reports look at activity in the last month, therefore if today's date is 2nd November, this will show activity for the month of October (if you need to run previous months you must set a relative run date).


The reports will highlight the following:

  • 6-in-1 - identifies patients with non-payment codes used last month and where medication issues are missing. 
  • Child Flu - identifies patients with non-payment codes.
  • Hep B- identifies non-payment codes and where a patient has been vaccinated at the wrong age. Patients vaccinated at the wrong age are information only for training purposes, no further action can be taken, and the patient will remain on the search.
  • LD health checks - identifies patients missing an annual health check code or where the health check has been completed after the action plan. For reference, the action plan must be completed on the day of the health check or after.
  • Men ACWY - identifies patients with non-payment codes.
  • Men B - identifies patients with non-payment codes.
  • MMR - identifies patients with non-payment codes.
  • PCV/Hib/MenC - identifies non-payment codes and where a patient has been vaccinated at the wrong age. Patients vaccinated at the wrong age are information only for training purposes, no further action can be taken, and the patient will remain on the search. 
  • Pertussis in Pregnancy - identifies patients with non-payment codes. 
  • Pneumo (PPA) - identifies patients with non-payment codes. It will also highlight patients that need to be coded with 'requires pneumococcal vaccine', the vaccine has been given but they are not eligible and this code will be needed for the payment. 
  • Rotavirus - identifies patients with non-payment codes. and where patients have been vaccinated at the wrong age or interval. Patients vaccinated at the wrong age or interval are information only for training purposes, no further action can be taken, and the patient will remain on the search. 
  • Shingles - requires the patient records to be reviewed, this could be due to a second dose missing, where the second dose has been given too early, incorrect payment codes, or a 'requires shingles vaccination' code is needed for payment.
  • Weight Management - identifies patients with non-payment codes.

 

Each search will include a sub-report, which will easily show the non-payment codes used or missing data. Click on the View Results option on the ribbon to display.



Practice staff must access each patient record identified and update accordingly e.g. enter correct payment code. The Ardens "Childhood Immunisation" and "Adult Immunisation" can be used for guidance on coding. 


Once the information has been entered and the reports are re-run the patients will no longer display in the reports. There maybe occasions, however, where patients remain on the list if they have missed the age range.


Please note - there are separate reports available for manual claims for Weight Management 2024-25.



Step 2 - Check and confirm claims

After the GPES extraction (around the 15th of each month) log onto the CQRS portal to check and confirm your claims. If there is anything that does not look right, move down to step 3.


Step 3 (if required) - Compare details of extraction

If you need to investigate any potential coding issues, you can compare the details of the patients extracted for payment (via GPES) with the Ardens "Monthly - overview" report.


Run the "INFO - Monthly- overview" report, the reports look at activity in the last month, therefore if today's date is 2nd November, this will show activity for the month of October (if you need to run previous months  you must set a relative run date). 



This folder contains individual reports for each vaccine, listing all patients who received a vaccination last month that were coded with a 'compliant code'. Additionally, the folder includes a summary report that compiles all patients for any vaccine recorded last month. You can export these reports to compare the list of patients to those that will be automatically extracted via GPES.


To view the CQRS automatic extraction via GPES, click on the "Enquiry Manager" tab located at the top of the Population Reporting screen.



Click on the globe icon at the bottom of the left-hand panel.



And this will show your GPES extractions by month. 




Select the month you wish to view (remember this is looking at previous month activity) and select "View in Search Manager" option on the EMIS ribbon. This will show the enhanced service (CQRS) extracted data, you can use the "Patient Included" tab to view the list of patients.


If there is a discrepancy and you believe that you should have been paid for that patient, you should then make a manual adjustment claim to CQRS.


Viewing Estimation of Auto Extract

The estimated searches are for guidance only and are NOT intended to be used for payment claims. We recommend following the steps above to ensure accurate payment and comparison of patient details.


 

If you require any further assistance on the process above, please contact Ardens support on: [email protected]