Ardens has written a suite of searches to help practices to avoid missing out on claims for personally administered drugs. The suite is not intended to be fully comprehensive of all claimable drugs, but has picked up on those most frequently missed by practices.
Please note - appearance in the searches does not mean that an item WAS personally administered and practices will know themselves which items they are eligible to claim. These are just intended as a guide and an aid only. If you missed submitting a claim for personally administered items in previous months, you can include those items in your next month's submission. Claims can be submitted for items dating back up to six years from the current month. Further information on backdated claims can be found here.
PPA Searches
To locate the searches navigate to Population Reporting > Ardens Searches > 1.36 Administration - PPA search folder.
There are 4 sub- folders included in the 1.36 Administration - PPA search suite.
Data quality - Patients with procedure but no Rx is the most useful folder. This details many different procedures which have been carried out in the previous month but where no prescription has been issued.
Each item has 2 entries, a search and a report. The search picks up on patients who have had a procedure (e.g. B12 injection) but who have not had a prescription issued for B12. Thus you will likely not be claiming for that item. The report shows details of when the procedure was done. Below shows you a few of the searches and reports:
Choose the report you wish to review and select the View Results option on the EMIS ribbon.
This will show you a report with details of the date on which the procedure was done, which will allow you to review the patient record and assess whether it would be appropriate to create a prescription for that item.
Info - Patients with procedure (regardless of Rx) helps you to identify procedures carried out based on activity coded in the patient record. This is just based on clinical codes and does not take into account of whether or not a prescription is issued. The names of the report identifies procedures looked for in the search. The search named 'patients with any of the below procedures last month' looks for all of the procedures in the one report.
Info - Report for Flu PPA claim provides a report to be used for the Flu PPA claim. Please note that Flu vaccines are seen as a high volume vaccine and does not require a prescription to be printed or recorded. The following report contains the basic flu information required for the claim. Some manufacturers may provide more than one type of flu vaccine and these types have different values. Therefore, just putting the manufacturer in your PPA claim may not be sufficient enough to ensure you get paid the correct amount for each vaccine and this may not be clear on the report. You may wish to cross match your batch numbers to find the vaccine type and add this information to the report to ensure you have all the relevant information to hand when completing your claim.
Info - Reports for claims (based on Rx issued) is a list of reports which details prescriptions which have been issued for each of the listed items. This is likely for reference only, as the prescription for these items have been generated.
When run, these reports have a huge number next to them - this is because they look at all patients. When you 'View Results' you will only see relevant patients who have had prescriptions issued in the time period.
Running the Searches
To use the tool, you may wish to run the whole folder 1.36 Administration - PPA, alternatively select the sub-folder/search you require. Note - the searches look to 'last month' by default. Thus if you run them on 10th July, they pick up activity for the whole of June. If you would like to review data from previous months, you can use the 'Advanced features' option when you run the folder:
This will allow you to change the Relative Run date to any date you like. The searches will then look back to the month BEFORE that date (i.e. date in June, looks to May, date in January, looks to December etc).
To assist the clinician, the following prompt will display when adding a procedure code in the patient record, reminding the user to issue a prescription.
Please note - depending on your practice coding, these reports may return procedures which were carried out elsewhere, so each case should be reviewed individually.
If you require any further assistance on the process above, please contact Ardens support on: [email protected]