Stop Smoking Payments and Claims


IMPORTANT INFORMATION Changes to the Stop Smoking service 
Public Health Hertfordshire would like to notify all Hertfordshire Pharmacists commissioned to provide Stop Smoking Services about a change to the service specification that is due to be implemented from 1 April 2019. This information has been sent out to all commissioned pharmacies via a PharmOutcomes message.

The change in question specifically relates to the financial arrangements for the provision of the Stop Smoking Service and applies to both GP Practices and Community Pharmacies. Public Health will have a new payment arrangement.  Pharmacies will receive:

  • £75 for each patient who sets a quit date and quits smoking for at least four weeks, and
  • £150 for each pregnant patient who sets a quit date and quits smoking for at least four weeks

As before, no payments will be made for non-quits, patients lost to follow up, patients without a set quit date or for incomplete data.

Access to NRT for the cost of a prescription (unless the service user is except from prescription charges) can be made by generating an NRT voucher through PharmOutcomes. Service users are free to present this voucher to any pharmacy participating in the NRT voucher scheme. Providers will continue to be paid quarterly on completion of quit status on PharmOutcomes. A change control notice will shortly be sent to Providers, giving 3 months’ notice of this change.

Public Health Hertfordshire acknowledges the hard work that providers do to ensure that Hertfordshire residents receive the services that they need and recognise that this is a significant change to the Contract, but hope that this does not deter any pharmacies from continuing to provide stop smoking services

The LPC was informed of this change in November 2018. Hertfordshire LPC would encourage all pharmacy contractors to review their own business model and whether it is still financially viable to deliver the service. We would encourage contractors to remain engaged with the service and would remind you that encouraging Medicines Counter Assistants to act as the trained advisors, if they are not already, is one way in which to potentially make the service more financially viable.

 

4 week quit status query report

There has been a significant drop in the number of quits compared to last year. A data audit has suggested that this could be due to the high number of clients who have not had their 4 week quit status recorded.

The query report will allow all service providers to view whether you have any clients with a pending or overdue outcome.

Pending means that it is time for clients to have their 4 week quit status recorded (after quit date with 25-42 days) on template 3.

Overdue means that it has been after 42 days since client set quit date therefore they are out of the outcome recording period. However it can be adjusted with back dating template 3 in order to record a valid outcome.

Please follow Query/Engagement report pathway to find your outstanding clients and record an outcome for them. Please find pathway among attachments. If the 4 Week Quit Status is not recorded then service providers will not be paid for any valid quits.

 

Stop Smoking Medications and Quit Claims 2018-19

The new invoicing procedure on PharmOutcomes allows for all invoices to be automatically generated according to data entered onto the database.
For GP service providers 1 item is claimable, 1. Successful 4 week quits.
For Community Pharmacy service providers, 3 items are claimable. 1. Successful 4 week quits, 2. NRT provided to clients accessing internal L2 service, 3. NRT provided as part of the NRT e-voucher processing template

You can preview your claims on PharmOutcomes at any time by clicking on the ‘Claims’ tab and then clicking on ‘Preview Claims’ button on the bottom left hand side. This action will pop up a window underneath the ‘Preview Claims’ button which you can click on when it becomes green. When you click on it your invoice will open and you can see all payments in different lines according to services you are entitled to claim for.

To view a claim breakdown please click on Claims tab where you will see your claim and in the same line on the right handside that following links:
If you click into ‘View Claim Breakdown’ it will include a breakdown of the products reimbursed specifically for your branch within the report.

Under ‘Claim Amounts’ section if you click on link you can find out about rules and deadlines for payment and how invoices are set up.
After invoices are approved by HHIS they will be visible on the right hand side under ‘Previous Claims’ title.

Common Queries
• Please ensure that you are entering the correct quantity of products. For NRT this is the number of individual products in the pack and not the number of packs. For example, please record 14 patches not 2 packs. If an incorrect product number is entered PharmOutcomes will produce an alert;
• Invoice dates: Any updates to clients 4 Week Quit Status made after the claim run date for that quarter can be awarded payment (if applicable) in the following quarter. Please contact HHIS if you record is shown as ‘Unclaimable’ to investigate it and get your payment in the following quarter.
• Invoice generated for £0 and comment ‘Do not generate payment: Claimable’: This means that you have recorded 4 week outcome status however it was not Valid Quit and Self-reported Quit therefore it did not qualify for payment.

If you have any further questions please contact Hertfordshire Health Improvement Service on 01442 453071.

How to preview your claims:

You can preview your claims at any time to date by clicking on ‘Claims’ tab and then clicking on ‘Preview Claims’ button on the bottom left hand side. This action will pop up a window underneath the ‘Preview Claims’ button which you can click on when it becomes green as it is on image below. When you click on it your invoice will open and you can see all payments in different lines according to services you are entitled to claim for.

Under ‘Claim Amounts’ section if you click on link you can find out about rules and deadlines for payment and how invoices are set up.

After invoices are approved by HHIS they will be visible on the right hand side under ‘Previous Claims’ title. It will look similar to table below and you can view your invoice by clicking on links on the right hand side.