Background

Tariff Configurations describe all the variables needed to process a submission and calculate the associated charges.  Tariff Configurations will normally operate over a period of 12 months and their expiry will usually align with the fincial year or appropriate contractually relevant date.

It is possible to implement several Tariff Configurations within a year, for example to represent changes in contract etc.  It is not recommended to implement more than one Tariff Configuration to be applied to the same data at the same time.

You can search for a Tariff Configuration for a Participating Provider or Commissioner for any given date here.

Change Items

A Tariff Configuration has the following items that can be changed:

  • Title:  The title associated with a Tariff Configuration, Pathway Analytics will normally issue the title, it will not normally be changed once the Tariff Configuration has gone Live.
  • Start and End date: This Tariff Configuration will be applied to submissions made by Participating Providers for the months between the Start and End dates (dates are inclusive).
  • Status: [Live: used for charging, Shadow used for purposes other than charging, Draft: Configuration is in review and cannot be used by a submission, Archived: a configuration that was used more than 12 months ago]
  • Lead Commissioner:  The nominated commissioner for making changes and specifying the Tariff Configuration details.
  • Participating Providers: List of providers whoes submissions made between the Start and End dates will be subjected to this Tariff Configuration.  If a provider has clinics subject to contractual arrangements described by a different Tariff Configuration, then the data for those clinics will be submitted to a new 'quasi' organisation that will be a Participating Provider of that different Tariff Configuration.
  • MFF: The Market Forces Factor applied to the raw tariff rates for each provider.  Only MFF or Geo Weighting can be used not both.  Where the Start and End Dates span a financial years, different Geo Weighting may be applied to each financial year.
  • Participating Commissioners: List of Commissioners within whose boundaries the Participating Provider's clinics operate.  If a provider has clinics subject to contractual arrangements described by a different Tariff Configuration, then the data for those clinics will be submitted to a new quasi organisation that will be a Participating Provider of that different Tariff Configuration.
  • Geo Weighting:  A factor, similar to MFF which is applied to the Raw Tariff rates according to the location of the clinic from which the care was delivered.  Only MFF or Geo Weighting can be used not both.  Where the Start and End Dates span a financial years, different Geo Weighting may be applied to each financial year.
  • Local Codes:  Codes not included in the published GUMCAD and SRHAD reports which are nonetheless necessary to track activity required to trigger the currencies in the Tariff Configuration.  The Lead Commissioner is responsible for specifying the description of new Local Codes.
  • Currencies:  A financial representation of a collection of care activities with similar costs and loose clinical relationship.
  • Primary Tariff Rate:  The raw Tariff Rate applied to the most expensive currency triggered in any episode or visit. 
  • Additional Tariff Rate:  The raw Tariff Rate applied to any other currency other than the most expensive triggered in any episode or visit.
  • Charge Host:  When set for a Currency, this Currency will only ever be charged to the local Host Commissioner of the Clinic delivering the care for the episode or visit ie the currency will not be cross-charged.
  • Currency Triggers:  The set of code combinations that may trigger a currency being charged in for an episode or visit.  Once a Currency has been triggered it cannot be triggered again within the same episode or visit.
  • Invalid Currency Combinations:  Certain Currency combination pairs can be considered invalid and when they occur they can be replaced with an alternative Currency. 

Ownership

Each Tariff Configuration has a Lead Commissioner.  The Lead Commissioner is responsible for ensuring their published Tariff Configurations are fit for purpose.  We will only accept change requests from the nominated Lead Commissioner for each Tariff Configuration.

Requests for Change

We are happy to receive requests for change by email, there is no specific format as each change can be quite unique, however, here are some points to consider when making a request:

  • Specify the tariff configuration you want to change, preferably with a URL link.
  • Be as specific as possible about the changes you want, use the same names and terms as we have if the Tariff Configuration is published.
  • Where the change involves a Tariff Rate, specify if the rates you are quoting include MFF or Geo-Weighting or not and if not if they need to be applied amnd what the rate is.
  • Where the change involves a Tariff Rate, specify BOTH the Primary and Additional Tariff Rates.  The Primary rate should be the full charge, the Additional rate should be the 'marginal' charge (the extra charge of of delivering this item alongside another).
  • Where the change involves the adoption of a local code because the activity you want to track is not recorded in the existing dataset, describe as specifically as you can (use the MECE principal) how the new code should be used.  Allow us to specify what the actual code will be. 
  • When rearranging existing chargeable activity into new currencies, consider how the code triggers in all currencies might be affected by the change.
  • Specify when you want the change to be adopted, if the adoption date is in the past, specify if you want prior submissions to be re-processed - we discourage this if possible.  We encourage changes to be made in line with financial or contractual year end.
  • If in doubt, contact us for guidance.

Example Request

By email to: enquiries@pathwayanalytics.com from: Lead Commissioner
Please add the following currencies to the tariff configuration: XXXX
PrEP Start | Pri: £XXXX | Add £XXXX (this DOES / NOT include MFF/G-W)
  SHHAPT = PREP3 | Starting a new course of PrEP (This code should be used for any patients starting a new course of PrEP at the current attendance)
PrEP Continue | Pri: £XXXX | Add £XXXX (this DOES / NOT include MFF/G-W)
  PREP4 | Continuing PrEP and attending for PrEP treatment (This code should be used for any patient returning for on-going PrEP treatment at the current attendance)
Changes should be made (select one):
a)  Immediately - the next submission made by providers will adopt these new changes (some providers may have made submissions up to different months)
b)  From Date XXXX - if a past date we will re-process any submissions, if a future date we may need to implement a new tariff configuration to onboard providers from that date - we will advise.