SLIDE 1 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Strengthening FP voucher service provision in BlueStar SF Network using Claims Processing Data Management System (CPDMS) Authors: Kanakulya Richard 1, William Nnyombi 1, Kelsi Kritimaa 1 Affiliation: 1 Marie Stopes Uganda

SLIDE 2 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Introduction MarieStopes Uganda (MSU) is implementing a five year program for provision of long acting and permanent methods (LAPM) of FP services. 75% of the targeted services are voucher based (targeting the poor populations), and 25% of services are targeting Cash clients The program works through 400 accredited Bluestar clinics across the country, where MSU reimburses the franchisees for voucher service provided. As MSU needed a system to help effectively monitor the voucher scheme implementation and be able to process claims on a timely basis, the ‘Claims Processing Data Management System’ (CPDMS) was developed

SLIDE 3 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Contract Mgt Project Supervision & M&E Contract Mgt Monitor service Quality & CME Contract Mgt Monitor service Quality & CME Design, distribution of Vouchers & BCC activities Design, distribution of Vouchers & BCC activities Voucher distributors Voucher Service providers MSU Voucher Management Mechanism Voucher recipients Accreditation, contracting and training VSPs Claims Processing & Reimbursement to Providers External relations & Advocacy

SLIDE 4 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Background Reimbursement and payment reports to providers were recorded using paper based records and Excel spreadsheet. The above systems were compounded by several challenges including; – Poor and slow programme monitoring and delayed reimbursements to providers. – None detailed program reports that can help management in strategic operations of the scheme

SLIDE 5 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Program Intervention MSU implemented the CPDMS, an SQL database to capture information that is used to focus resources and increase efficiency of FP-service provision (program monitor and timely reimbursements to providers) Implemented in February 2011, the CPDMS captures: a)FP clients’ bio data and geographic information and the information on the PGT b)Medical & Reproductive history and FP method taken c)Complications reasons and treatment given d)Reason for FP removal and FP charges in each module  The CPDMS currently provides:  Timely information used for generating service numbers, performance reports & reimbursement reports.  Used to Quarantine claims, reject claims & fraud control

SLIDE 6 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) System operation Claims submitted to MSU offices by VSP Claims received is recorded by Admin Assist Claims are entered in the system Reimbursement report are generated by finance team System checks adherence to CP system Medical Advisors vetting claims Payment processed and VSP paid VSP provides service STOP START  The beneficiaries of the CPDMS are BlueStar managers, Research Monitoring & Evaluation department, Finance department and other stakeholders MarieTXT-SMS platform enabling real time reporting and communication with CBDs and service providers Voucher distribution to clients

SLIDE 7 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Program Intervention With Integration of the SMS platform (MarieTXT) in CPDMS; The system has an interactive platform to continuously share information between Voucher management agency (MSU) & service provider (VSP) and the community based distributors of vouchers(CBDs). The SMS platform has been linked to the Hotline for more interaction with the clients, VSPs & CBDs. Coupon for provision of service Coupon for management of complication/side effects Coupon for removal of method

SLIDE 8 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Key findings The CPDMS has made FP claims processing faster and more efficient than the initial systems with; – Fast and improved data validation to check fraud and other inconsistencies from the voucher scheme and service delivery. – Improved FP data management for decision making through routine tracking of voucher services and generating detailed reports both programmatic and financial. – Enhanced security and access authentication at different modules and levels with over 100 users able to be logged on at the same time

SLIDE 9 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Program Implications/Lessons Due to the efficiency of the CPDMS in processing FP data, BlueStar management has been able to process FP claims for providers efficiently and has been able to make evidence based decisions through reviews and routine monitoring and evaluation.

SLIDE 10 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) MarieStopes Uganda staff processing FP Claims

SLIDE 11 Strengthening Family Planning voucher service provision in BlueStar Social Franchise Network using Claims Processing Data Management System (CPDMS) Contact information for MSU: Thank you for your attention!