How commvita prices commissioned activity, applies a statutory means test, raises a private invoice and captures value-based revenue — with every price, threshold and cap held as sourced, effective-dated configuration rather than a constant in the code, and with an honest account of where the platform stops and the finance ledger begins.
The same visit can be paid for in entirely different ways depending on who is paying: a national tariff, a means-tested contribution, a private fee, or a per-member payment with risk adjustment on top. Most systems solve this by having a separate product for each, which is how an organisation ends up reconciling four sets of numbers that all claim to describe the same activity. commvita records the activity once and treats how it is paid for as configuration.
Two decisions in the data model that a finance team will care about more than any screen.
National prices, best-practice tariffs, day-case and outpatient prices and per-diem rates are stored as integers in pence. A price therefore cannot drift by a rounding error between two organisations reading the same rate, and a total is exact rather than nearly right.
TariffRate.national_price_pence · bpt_price_pence ·
day_case_price_penceAn effective-dated payment scheme holds the national rates; a locally agreed price attaches to an organisation code; recorded activity costs sit alongside for reference-cost comparison. England's NHS Payment Scheme is seeded for 2024/25 and 2025/26 alongside a Crown Dependency health tariff, which is what makes the model multi-jurisdictional rather than England-with-exceptions.
TariffScheme · TariffRate · TariffLocalPrice ·
ActivityCostRecordThe figures that decide what a person pays are not constants in the source. They are entries in the Jurisdiction Profile — each with the instrument it comes from, the date it took effect, and a review date. This is the difference between a system that can be audited and one that has to be trusted.
| Value | Figure | Source recorded with the entry | Effective from |
|---|---|---|---|
| Care Act upper capital limit | £23,250 | Care and Support (Charging and Assessment of Resources) Regulations 2014, reg. 12 | 1 Apr 2015 |
| Care Act lower capital limit | £14,250 | Care and Support (Charging and Assessment of Resources) Regulations 2014, reg. 12 | 1 Apr 2015 |
| Lifetime cap on eligible personal care costs | £86,000 | Care Act 2014 s.15 (implementation from October 2025) | 1 Oct 2025 |
| NHS dental Band 1 / 2 / 3 | £26.80 · £73.50 · £319.10 | NHS Dental Charges Regulations 2024/25 (FP17 course of treatment) | 1 Apr 2024 |
| Optical voucher, band A | £42.30 | NHS General Ophthalmic Services — optical voucher value band A, 2024/25 | 1 Apr 2024 |
Payment schemes, an HRG browser, an activity costing calculator and locally agreed prices, with QOF achievement and enhanced-service activity recorded against their own contracts. Cost per activity is compared against reference cost through patient-level costing.
The Care Act means test with capital thresholds, tariff income of £1 per £250 of capital between the limits, and minimum income guarantee protection. Personal budgets are held as a direct payment, a managed budget or a third-party arrangement, each with its own ledger and a personal-assistant employment record. Eligible costs accrue toward the lifetime cap in a care account, with the local-authority liability forecast alongside.
A fee schedule based on the BMA rates, invoice generation with VAT and line items, an outstanding-debtor view and finance reporting. Chargeable medical reports — firearms, driver medicals, insurance and similar — close the loop below.
PrivateFeeItemPrivateInvoiceLiveTime-tracked care management billed under its own codes — chronic care management (99490 / 99491 / 99439), collaborative care (99492 / 99493 / 99494), transitional care (99495 / 99496), principal care management (99424 / 99425), the annual wellness visit (G0438 / G0439), remote physiologic monitoring (99453 / 99454 / 99457 / 99458) and remote therapeutic monitoring (98975–98981) — with the minimum-time and minimum-day thresholds tracked rather than assumed. Risk adjustment, quality and readmission programmes sit alongside.
Legal entities, cost centres, contracts and payroll runs with an approve, lock and pay workflow and variance flags; income and expenditure by service line.
HRPayrollRun · HRServiceLinePLPatient-level costing against reference cost, service-line reporting, and a cost-of-delay meter that prices the queue holding the line at the excess bed-day cost — so an operational decision carries a number.
Efficiency schemes tracked against a target with a delivery trajectory, procurement routed through the Provider Selection Regime, and supply-chain spend with supplier performance. The commissioner a contract is held with is not fixed — boards have merged, and government has signalled an intent to align their boundaries with the new strategic authorities — so the commissioning map is sourced and effective-dated rather than hardcoded.
Prior authorisation and documentation templates on the Da Vinci implementation guides, claims ingestion over X12 EDI, admission and discharge notifications to payer case managers, quality measure submission, and good-faith estimates for uninsured and self-pay patients under the No Surprises Act.
The scheme of reservation and delegation and the standing financial instructions are held as an effective-dated matrix of role, decision, limit and instrument. Spend above a threshold runs as a gated approval — assignable to a role, a named person, or a whole team — escalating on a service-level breach, optionally signature-backed, and written to an append-only hash-chained audit that is re-verified whenever it is read.
P2PAuthorityRow · P2PApprovalTask| Capability | Route | API / model | Status |
|---|---|---|---|
| Payment scheme, rates, local prices, activity cost NHS Payment System | /nhs-payment-system | GET /tariff/ · TariffScheme · TariffRate · TariffLocalPrice · ActivityCostRecord | Live |
| Statutory financial values, sourced and dated Jurisdiction Profile | /jurisdiction-profile | GET /jurisdiction-profile/ · financial domain | Live |
| Care Act means test, tariff income, MIG Financial Assessment | /financial-assessment | GET /financial-assessment/ | Live |
| Personal budgets and PA employment Direct Payments | /direct-payments | GET /direct-payments/ | Live |
| Care account and lifetime cost cap Care Act Cost Cap | /care-act-cost-cap | GET /care-act-cost-cap/ | Live |
| Care package costing and provider rates Care Package Finance | /care-package-finance | GET /care-package-finance/ | Live |
| Fee schedule, invoice, VAT, debtors Private Patient Charges | /private-charges | GET /private/ · PrivateFeeItem · PrivateInvoice | Live |
| Billing rules and tariff mapping Billing Rules Engine | /billing-rules | — | Demonstrated |
| Chargeable report → signature → invoice commvita Sign | /esign | POST /esign/sign · _esign_raise_invoice | Live |
| Chronic, collaborative, transitional, principal care US care management | /ccm · /collaborative-care · /transitional-care · /pcm | GET /ccm/ · /bhi/ · /tcm/ · /pcm/ | Live |
| Annual wellness visit, RPM, RTM US preventive and monitoring | /awv · /rpm · /rtm | GET /awv/ · /rpm/ · /rtm/ | Live |
| Risk adjustment and recapture HCC coding · RAF Recapture | /hcc-risk-coding · /raf-recapture | GET /raf-recapture/ | Live |
| Quality-linked revenue STAR Ratings · Readmission Prevention | /star-ratings · /readmission-prevention | GET /star-ratings/ · /readmission/ | Live |
| Payer interfaces Prior Auth · Payer Data Feeds · No Surprises Act | /prior-auth · /payer-data-feeds · /no-surprises-act | Da Vinci PAS · X12 EDI | Demonstrated |
| Payroll, cost centres, service-line P&L HR & Finance | /hr-finance | GET /hr/ · HRPayrollRun · HRServiceLinePL | Live |
| Patient-level costing and cost of delay commvita Flow | /flow | GET /flow/ | Demonstrated |
| Total cost of care against benchmark TCOC Dashboard | /tcoc-dashboard | — | Demonstrated |
| Efficiency programme and procurement ICB Commissioning | /icb-commissioning | GET /icb-commissioning/ | Demonstrated |
| Delegated financial authority and gated spend Policy-to-Process | /policy-to-process | GET /p2p/authority · P2PAuthorityRow | Live |
| Finance system of record Integrations Hub | /integrations-hub | SAP S/4HANA · Oracle Fusion · Workday | Demonstrated |