Right time measure using treat as made dates

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  • #33835
    chris harvey
    Participant

    Thought I would share with you stats bods some clarification I have received from the DWP surrounding the way treat as made dates for advance claims impact on right time calculations.
    I had finally found some time to try and reconcile the time taken to process a new claim when a TAM date is present. I discovered that a number of cases which I thought would use the TAM date in preference to the receipt date were actually using the receipt date and were reporting longer processing times than anticipated. This lead me to drill into the logic that the DWP use contained in their derivation rules.
    I quickly identified that the derivation rules apply a strict interpretation of an advance claim under HB reg 83 (10) or CTB reg 69 (12). These regs state that an advance claim is treated as being made in the week before entitlement begins. So the coding in the derivation rules always looks for a TAM date in the week prior to the start date of the claim. If the TAM date is not in the prior week it is ignored and the measure uses the receipt date to calculate processing time.
    This was important as many of my assessors were entering a TAM date as the date they wanted entitlement to begin rather than the prior week and as a consequence the TAM date was being ignored when calculating performance.
    I then discovered another issue which I have had to seek clarification from the DWP. Sometimes due to backlogs we get an advance claim but do not manage to process it in time for when entitlement begins. For example an advance claim is made on 1st March, it is an advance claim to start on Monday 5th April, so a TAM date is the week before say 1st April.
    Due to backlogs the claim is processed on 1st May. In circular A13/2009 Appendix 2 Para 8 the rules for advance claims are succinctly summarised “when a claim to HB is made in advance under HBR 83(10), 83(11), the processing time starts from the date the claim is treated as made (TAM) by the LA under those regulations. If the claim is properly decided on or before the TAM date, the time taken to process the claim for the purposes of the performance indicator will be one day. Otherwise the processing time will be from the TAM date to the date the decision is made”. To me this indicated that the processing time should be from the TAM date to the process date (1st April to 1st May). Yet the cases were being counted from the receipt date to the process date (1st March to 1st May).
    Louise Hughes at the DWP Performance Division has confirmed that in this scenario the TAM date is not used, I quote “If the decision is not made until after the TAM and the entitlement start date, then processing time is counted from the claim received date to the date the decision is made”
    So in a nutshell TAM dates are used only where they are in the week prior to the start date providing they are processed before the entitlement start date.

    #47741
    bod
    Participant

    DWP SHBE Derivation Rules in DWP HB Full Specification V1.4 July 2009 document (page 40) provides 5 Treat As Made [TAM] Date scenarios;

    18. TAM1-TAM5: Treat as Made scenarios. The scenarios detailed below give a range of possible TAM outcomes. All the scenarios cover a calculation period of one month.
    • TAM1: Treat As Made (TAM) date before received date, ignore TAM date when calculating processing times, calculate processing times as difference between decision dates and received dates.
    • TAM2: TAM is in the same week as the claim was received. Therefore ignore the TAM date when calculating processing times, calculate processing times as difference between decision dates and received dates +1.
    • TAM3: TAM is in the week following the received date (or later) and the entitlement start date is in the same week as the TAM date; when calculating processing times, calculate processing times as difference between decision dates and received dates + 1.
    • TAM4: TAM after decision date and TAM is in week before start of elibility. Processing time = 1 day.
    • TAM5: TAM is in the week following the received date and the entitlement start date is in the week following the TAM date. Calculate processing times as difference between decision date and TAM +1.

    Have I misread this? I can’t see where deciding the claim after the TAM Date & after the Entitlement Start Date results in the TAM Date being ignored and the Receipt Date being used instead to calculate performance.

    😕

    #94085
    chris harvey
    Participant

    Hello Bod

    The actual logic used is on page 27 of the DWP spec and the 5 TAM scenarios on page 40 flow from that.
    If you look at the 5 TAM scenarios you will see that it is only the last 2 (TAM 4 and 5) that use the TAM when determining performance. TAM 1, 2 and 3 all use the receipt to the decision dates.
    Looking at TAM 4 and 5 neither would apply in the scenario where the decision date is after TAM date because TAM 4 covers where the decision date is before the TAM and TAM 5 only applies where the TAM is in the week after the receipt date.
    My scenario where the decision date is after the TAM date is not covered specifically by any of the 5 TAM scenarios but the logic on page 27 has a catchall at the end that says if none of the logic applies you use the receipt to the decision dates to calculate performance.

    #94086
    Anonymous
    Guest

    Would the following fall into advance claim rules?

    Claim was received on 16/04/2010
    Was in hospital and didn’t move in until 24/05/2010

    Should the claim made 16/04/2010 be treated as an advance claim

    Should the treat as made date be the week before 24/05/2010?

    We use academy and i cant see any TAM fields, do other academy users input the TAM date as the receipt date ?

    #119500
    gillymac25
    Participant

    Hi Chris,

    Just bumping this up to see if you knew if the situation with TAM dates was still the same? I don’t think we’ve ever used them in this way. A lot of the time we use the TAM date as the date moved in or date liability started (whichever is later). We are also not in a position to process claims before the entitlement start date as we wait for confirmation that the customer actually moved in.

    Just looking for clarification if possible??

    Thanks,
    Gillian. 😀

    #119512
    chris harvey
    Participant

    The DWP derivation rules have not changed so the position is still the same Gillian.

    #119788
    gillymac25
    Participant

    Ok thanks Chris, need to have a look into this and see what we’re doing wrong….!

    Thanks again,
    Gillian.

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