A description of each sheet follows.
This page is a brief summary of your register and financial information including FFS deductions for the month.
On the right side of the page, there are clickable links to each of the sheets in the spreadsheet. To return to the summary page just click Home (in cell B2) on any of the other sheets.
There are two tables on this sheet. Together they give you a monthly analysis of the funding streams for the practice for the current month and over time. All amounts are GST exclusive.
Payments (excl GST) for Current Month
This shows the monthly financial calculations for this month. It includes First Contact Care (your core payment) and, where applicable, the VLCA, U6, U14 and CSC amounts. Your monthly FFS deductions are also included in this and subtracted from the total.
Where requested (via the PHO) this table will be broken down by provider. Note the provider information is from the provider specified in NES, not the PMS, changes to the provider need to be updated in both the PMS and NES for this report to be updated. Funding for patients that are not allocated to a valid provider in NES will be included as such in this table.
Practice Monthly Total
This table gives the practice monthly totals for First Contact Care for each month based on your practice’s Funding Model (VLCA, CSC, Under 14 etc) at the time.
Note there is no FFS information available prior to the start of NES in April 2019.
There are two tables at the top of this sheet. The table on the left shows you the funded patients (as at the 1st of the month) by month and the change over the month (new patients coming in and patients that have been terminated). The first row only has the currently funded patients as it is not yet known how many new and terminated patients you will have as this is only known at the end of the month.
The table on the right shows you a break down of all of the terminated patients by the reason for termination. This reason has either been generated automatically by the MoH or when you have done a manual enrolment end and will be the reason that you entered in NES.
For details on your terminated patients, see your Register Update spreadsheet
The third table shows the total enrolments (when requested this is by provider) for the current month, it also shows the number and percentage of patients in the practice that currently hold a Community Service Card or a High User Health Card.
There are two graphs of your practice monthly totals from the previous sheet. It illustrates changes in the patient numbers at your practice over time. For example, the data may indicate it is a good time to make decisions about accepting new patients.
Please note the scale of the funded patients over time can make changes look more significant than they actually are - you can use the Format Axis facility in Excel to set the minimum value to 0 for a different view of the changes.
This sheet gives you further analysis of your population and the First Contact Care (FCC) funding received for them. Note: Any patient with an unknown gender on NES/NHI is NOT included in these tables - this may mean there is a small discrepancy between this sheet and the Summary sheet - the Summary sheet is the information that will be used for your funding. Refer to your Register Update spreadsheet for the details of patients with an unknown ethnicity.
The first table at the top of the sheet shows you the breakdown of your patients by all the categories that affect FCC funding of age, gender and card status. The funding will be different if the patient has both a CSC and HUHC so the count of those patients is shown in a separate column. The First Level Service amount shows the base level funding for patients (without the application of any other funding schemes you may have signed up for).
The subsequent tables show the additional funding that you are entitled to for the other funding schemes you have signed up for, that is if you have signed up to the CSC, Under 14 or VLCA subsidies. Note there is no CSC subsidy for Under 14s as this is covered in the Under 14 subsidy.
On this sheet, there are multiple tables and graphs with information about the demographics of the patients in your practice.
Age Group Breakdowns:
This table shows the number of patients broken down by age group and gender. It is used as the basis of the first graph on the right. It is worth looking closely at the age and gender distribution of your practice as this will have a significant impact on the service utilisation (i.e. how often people visit your practice). It is also important to notice whether you have nearly equal numbers of men and women enrolled in your practice.
By Ethnic Group:
This table shows the number of patients broken down by age group and ethnic group (based on the priority ethnicity ranking). This table is used as the basis of the graph to the right. It is worth looking closely at the age and ethnicity distribution of your practice as this will have a significant impact on the service utilisation (i.e. how often people visit your practice).
This table shows the number of patients broken down by age group and quintile. This table is used as the basis of the graph to the right. This shows the number of patients in your practice in each quintile. Each quintile in the New Zealand population is around 20%: slightly less in Quintile 1 (18%) increasing to slightly more in Quintile 5 (21%). You should expect a number of patients to have an unknown quintile - an explanation of the reasons for patients have an unknown quintile can be found here.
High Needs Analysis:
This first table (Patient Register by Ethnic Group and Deprivation Index) shows the breakdown of patients in the practice by deprivation index (or quintile) and Maori, Pacific and Other categories. Note that the percentages are a percentage of the total register.
The second table (LCAF Analysis) shows the total patients who qualify as 'high need' patients (Maori, Pacific, Dep 5), giving the total "High Needs" patients for the PHO. If the percentage is over 50%, your practice is a "High Needs" practice and would qualify for the VLCA scheme.
These two table are 2 different ways of looking at the monthly Fee for Service deductions.
FFS Deductions by Month of the Deduction
This table s a view based on the month of the deduction so this represents the amount that was deducted for a given month. The visits that contribute to that deduction have not necessarily taken place in the previous month so this is not a good representation of claims in a given time but will tally with the payment amounts in the previous sheets.
The graph to the right of the table shows total FFS deductions (for a maximum of the previous two years) in graph form.
FFS Deductions by Month of the Visit – note the last 2 months are not included as not all visits have been claimed yet.
This table shows the number of FFS deductions that your practice has had based on the date of the visit (rather than when it was claimed as per above), it won't match the $ amount deducted but is a representation of the number of GMS visits that were made in any given month.
The graph to the right of the table shows the total number of FFS visits (for a maximum of the previous two years) in graph form.
This can assist you to track trends and whether changes in opening hours or doctor availability has had an impact on the number of your patients who are seeking services elsewhere.
The third graph on the page shows the average deduction per patient (all patients funded for the month) by the month of the visit from the second table. The level of this amount is an indicator of the overall cost of the FFS deductions across all your patients.
FFS This Month Detail Sheet
This shows all FFS deductions for your practice. Do NOT contact patients about their reasons for visits elsewhere. They are entitled to do this, although if a patient has had a significant number of visits elsewhere, you may contact them to see if they still want to be enrolled with your service.
The table also shows the day of the week of the visit. Lots of weekend visits possibly indicate visits to after-hours clinics. It also shows the date of the last visit (DLV) with you. You may want to compare DLV with the information on the six months total sheet.
There is also the list of providers on this sheet that can be filtered, this can be helpful to see what the impact may have been of a particular Doctor being unavailable.
FFS This Month Totals Sheet
This table shows the total FFS Deductions for this month. It shows the total dollar amount that has been claimed for each patient, with the highest total at the top.
FFS Six Month Totals Sheet
This table shows the total FFS deductions for your patients for the last six months. It shows the total visits and the total amount of the deductions for each patient over the last six months.
For comparison, the last column shows the total amount of First Contact Care funding for six months (based on the current months funding).
Note: This sheet is looking up historical records, so may not be accurate
- for the first 3 months of NES, or
- if you have not yet been with your PHO for 6 months
- your PHO has not had its data processed for 6 months by Karo
Some FAQ’s for FFS
1. Why is the FFS amount deducted sometimes $0?
The FFS amount paid is the amount paid to the other doctor the patient visited. The FFS deducted amount is the amount deducted from your PHO. Usually, they are the same but if the patient goes elsewhere more than three times in a month, the fourth and subsequent visit is not deducted from your PHO.
2. Why do I keep getting FFS deductions months after a patient has transferred to another practice?
The other practice that saw the patient has up to three months to lodge the casual GMS claim with MOH. If the patient visited the other practice on 28 Feb and that practice was a bit slow to get their claims in (maybe their practice manager was on leave), the claim may not be lodged with MOH until the end of April. HPAC would then process that claim during May and the FFS deduction would come to the PHO/practice in June. So it is possible for you to still be getting FFS deductions four months after a patient has transferred from your practice.
If you are concerned about the validity of a deduction, you need to look in your FFS spreadsheet and note the 'date of the visit' that the claim was for (N.B. not the 'date of the deduction'), then check back on your PMS to see if the patient’s enrolment on NES was ended after that date.