Online Interface With ACC Focus on the Medical Certificate

Transcription

1 Online Interface With ACC Focus on the Medical Certificate RNZCGP September 2012 Agenda Paper / PMS Generated Medical Certificates Online Medical Certificate (eacc18) Benefits & Challenges Where At & Near Future Parting Messages 1

2 Online Medical Certificate An Intro ACC18: ACC receives approx 225,000pa Completed on paper or within Practice Management System (PMS), printed off and sent or faxed to ACC Requires manual processing / input by ACC eacc18: Practitioners access through PMS; once <submit> button is pressed, admin is complete August % uptake January % uptake August % uptake Enhancements responded to quickly and with minimal impact on Practices or PMS eacc18 - Benefits For the Patient: Faster and better support: ACC is able to respond quicker as the form contains more detail and is received earlier than fax, post, or . For the Practitioner: Less re-work: Fewer queries from ACC seeking further information or questioning content. For Practice Managers: Simpler process: There is no need to fax, post or the form to ACC. For ACC: It enables more accurate, faster decision-making on support for patients. For Your Practice: It's a step towards the inevitable move to working online, and the process efficiency benefits. 2

3 eacc18 - Patient claims eacc18 - Injury Tab 3

4 eacc18 - Fitness for Work Tab PATIENT eacc18 From July 2012 PROVIDER PMS TRee (secure connection) BPAC TRee INTERNET Back-up Process FIREWALL ACC18 Mailbox Eos Dunedin Scanning Team 4

5 eacc18 - Challenges First Cabs Off The Rank - Uptake Lag: Takes time for Practitioners to build new habits Elder Practitioners come on board with one-on-one support Internet & Practice Technology Speed: Housekeeping - Clear.tmp files from server Data Caps Some practices have monthly limits Parallel New Business Processes: Success has resulted in further expectations Practice Managers As Trainers: ACC acknowledge you are busy; keep up the good work Encourage Practitioners to use the online Training Tool eacc18 - Where At & Near Future Practices: 665 deployed; 528 used in August Practitioners: 3160 deployed, 2112 used in August PMSs: Medtech & Profile for Windows now, Houston & MyPractice by the end of September eacc18 Near Future: Supporting Return To Work Initiative from 1 October Stand Alone Version MD Guidelines Other Online Forms: eacc45 - Trialling with MyPractice Online Physio Forms - In production with key pilot sites using Medtech & Peak 5

6 From 1 October Return To Work From 1 October New Support Type of assistance Support needed to stay at work / return to work ACC action ACC will contact you, your patient and their employer to identify and then put in place the most appropriate type of assistance to support your patient to stay at or return to work. Examples of assistance are the Stay at Work service, some equipment, or help getting to and from work. You can use the Complications / assistance required field to type in any additional information about the type of assistance your patient needs. Clinical review of patient s fitness for work needed ACC will contact you to check that it is appropriate to refer your patient to an independent medical practitioner who will complete an assessment of the patient s fitness for work (to support you with assessing your patient s fitness for work). ACC will contact your patient and their employer regarding the referral. 6

7 From 1 October ACC to contact me Parting Messages Online Forms Benefit all: Patient, Practitioner, Practice Manager, & ACC Are becoming an integral part of doing business Assist your Practice & Practitioners now ACC is providing additional support for eacc18 roll-out at this time Good preparation for what else is coming eacc18 Support Contact Points Self Service: keyword = eacc18 Self Service. Support: Call option 1 ebusinessinfo@acc.co.nz 7

8 Questions Thank You The following are a bunch of slides in case they add value based on questions asked. 8

9 Current Interaction Model Future Interaction Model Externalised decision and streaming model. Providing relevant rules and guidelines at time of consultation. Substantially automated processing with few (or no) paper forms. Greater focus on Exception Management and a reduction in processing time. Relevant information is available to ACC and external customers in a timely manner. 9

10 Staged Approach Read Codes 1 Why are you making these changes? It is important that ACC systems reflect the diagnoses codes that are used by our health sector, and that the chance of error is minimised by limiting the list to diagnosis related codes. Where is the updated Read Code list? The updated Read Code list is available here. What do I need to do? The new code list will be effective from 26 February After that date, the updated code list must be used. ACC will no longer be able to receive claims for diagnoses that are not on the list. This includes treatment injury and occupational disease, infection and gradual process. 10

11 Read Codes 2 What codes have you removed? Codes that are not for a diagnosis of injury have been removed. These are things like family histories, medical supplies and non-injury symptoms. ACC has reviewed claims that were lodged using these codes, and is satisfied that there is an appropriate alternative for any that have been used to indicate injury. What about our Practice Management System (PMS)? Does this need to be updated? You do not need to do anything, as there will be no change to your PMS. The change is being made to reflect what ACC is able to receive and how codes are mapped within ACC systems. This sits outside your PMS. Read Codes 3 Why aren t ACC moving to SNOMED CT? Moving to SNOMED is a substantial change for providers and for ACC. We will make the move in conjunction with other organisations when we have enabled our systems and when we have the resources to assist Providers with the transition. Our staff complete manual claims and don t have access to a computerised code list. How do we know what to use? ACC will provide a list of alternative options for commonly used removed codes. If manual claims are received with removed codes, ACC will be unable to accept this code and will ask for it to be corrected. The alternative codes will be published on our website in January

12 Read Codes 4 What Read Codes are being removed? There are over 57,000 Read Codes being removed from the current list; mostly Read Codes that have no relevance to ACC and injury. They are for things like medical supplies and histories or symptoms of conditions. Careful analysis has ensured that the codes that are being removed are very rarely used, should never have been used or have common and comparable alternatives. Read Codes 5 Whilst the change will mean we are more consistent with Providers it will not guarantee that we are in complete sync with their Practice Management System as we are not insisting that their systems be changed. Rather, the new electronic claim form which will be piloted in 2012 will use the updated Read Code list (and ultimately the ICD-10 list). Over time, this means that ACC has control over the injury diagnoses codes that are available for lodgement. 12

13 Read Codes 6 In Medtech - how to make the change to the new ACC Read Codes? We advise the practice to find the closest read code. We can't update the read code, MedTech has to do it Read Codes 7 27 August: Medtech have been provided with: 1. a replacement shortened Read Code list to make available. 2. a highlighted error when using their search 13

14 Paper ACC18 is not online 14

15 Medtech ARC18 is not online MyPractice ACC18 is not online 15

16 Paper / PMS Generated ACC18 Downsides Requires Practice to fax, post, or to ACC Takes several days to reach ACC Case Owner Often requires ACC to seek further information/clarification Not keeping up with process efficiency benefits Not providing latest service offering to patients Upsides Current habit for Practitioner Bit of initial set up for eacc18 is not undertaken eacc18 - FFSW Pop Up 16

17 eacc18 - Declarations Tab eacc18 - Final Steps 17

18 eacc18 - Output 18