Primary Health Care

Capitation Payments: Monthly Payment Processing

Background
Payment Process Workflow Diagram
Capitation Monthly Payment Reports and Buyer Created Tax Invoices
Examples of Monthly Payment Reports
Purchase Unit Codes

Background

The payment process workflow occurs with different frequencies to that of the quarterly register process (i.e. monthly or on demand). In the first instance, ProClaim divides the quarterly capitation amount from CBF into three equal amounts which in turn is the starting amount for the monthly payment.

Prior to the monthly payment run, or on an as required basis, financial adjustments are netted off from the calculated payment amount and subsequently paid from Proclaim. An electronic Buyer Created Tax Invoice (BCTI) is generated and submitted to the PHO to advise of the net amount to be received into the PHOs bank account.

Prior to funds transfer, the DHBs have a 5 day window to stop the payment should they disagree with the adjusted amount calculated.

Transactional reports, such as the BCTIs, FFS deduction reports, Cashflow statements, etc. are generated by either CBF or Proclaim to provide DHBs and PHOs with basic financial information.

Payment Process Workflow Diagram

Monthly Payment Process Workflow (Word, 86 KB)
Monthly Payment Process Workflow (PDF, 81 KB)
Monthly Payment Process Workflow (VSD, 122 KB)

Capitation Monthly Payment Reports & BCTI

Capitation Monthly Payment Reports & BCTI (Word, 73kB)
Capitation Monthly Payment Reports & BCTI (PDF, 25 KB)

Examples of Monthly Payment Reports

Purchase Unit Codes (PUC)

The list of purchase unit codes to be inserted as relevant into the Agreement Request Form when generating the Standard PHO-DHB Primary Care Service Agreement.

Primary Care Purchase Unit Codes (PDF, 53 KB)

Please note this document is currently undergoing a review due for completion by June 1 2007. In the meantime if you have any queries about the contents of the document please direct them to cbf_admin@moh.govt.nz

Page last updated: March 2007