Prescription Charges and Endorsing


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Prescription Charges and Endorsing

  1. 1. Prescription charges & endorsing Don Page, ID
  2. 2. Prescription Charges <ul><li>Abolished for Scottish prescriptions written and dispensed in Scotland </li></ul><ul><li>Patient signature on reverse still needed </li></ul><ul><li>No charge for Welsh forms </li></ul><ul><li>No charge for Northern Ireland forms </li></ul><ul><li>England forms pay at English rate </li></ul>
  3. 3. England forms <ul><li>Current charge is £7.40p (1 st April 2011) </li></ul><ul><li>Patient residence entitlement card </li></ul><ul><li>Exemption categories in Annex B </li></ul><ul><li>Patient must sign rear and tick correct exemption category </li></ul><ul><li>Person signing the back is responsible for the claim </li></ul>
  4. 4. Charges per item <ul><li>Normally one charge per product </li></ul><ul><li>Multiple charges if more than one product in the container (e.g. HRT tablet & patch) </li></ul><ul><li>One charge for different strengths of product (e.g. titration pack) </li></ul><ul><li>Contraceptive items are no charge </li></ul><ul><li>Hosiery is one charge per piece </li></ul>
  5. 5. Examples <ul><li>Warfarin 1mg tablet </li></ul><ul><li>Warfarin 5mg tablet 1 charge </li></ul><ul><li>Stockings (2 pairs) 4 charges </li></ul><ul><li>Microgynon 30 No charge </li></ul><ul><li>Prednisolone 5mg GR tablet </li></ul><ul><li>Prednisolone 1mg tablet 2 charges </li></ul><ul><li>Diclofenac Sodium 50mg GR tablet </li></ul><ul><li>Diclofenac Sodium 100mg MR tablet 2 charges </li></ul><ul><li>Canestan Duo-pack (cream & tablet) 2 charges </li></ul>
  6. 6. ENDORSING <ul><li>The purpose of endorsing is to communicate to PSD what actually happened </li></ul><ul><li>The pharmacist can see the prescription and the item that was dispensed. PSD can only see the prescription </li></ul>
  7. 7. A SCHEMATIC APPROACH <ul><li>Item name </li></ul><ul><li>Brand or maker (if applicable) </li></ul><ul><li>Formulation type (if applicable) </li></ul><ul><li>Strength or dimensions (if applicable) </li></ul><ul><li>Pack (if applicable) </li></ul><ul><li>Quantity </li></ul>
  8. 8. Item Name <ul><li>This is usually not an issue </li></ul><ul><li>Ensure that if the prescription is hand written that it is legible </li></ul><ul><li>Also check the spelling of the item </li></ul><ul><li>If you need to substitute the product completely, it is good practice to get the prescriber to initial the change if possible </li></ul>
  9. 9. Brand or maker <ul><li>The pricing computer can link the brand name to the non-proprietary identifier </li></ul><ul><li>Brand names are needed for some modified release products e.g. Nifedipine </li></ul><ul><li>Maker’s names are needed for some homeopathic products </li></ul><ul><li>Manufacturer codes are essential for most medical devices apart from dressings </li></ul>
  10. 10. Formulation Type <ul><li>The formulation type is commonly omitted from hand-written prescriptions </li></ul><ul><li>The computer will default to tablet over capsule unless more cost-effective </li></ul><ul><li>Likewise, cream will be given precedence over ointment </li></ul><ul><li>You can indicate if you have to change the formulation type </li></ul>
  11. 11. Strength <ul><li>Again this is commonly omitted from hand-written forms </li></ul><ul><li>The computer will default to the most cost-effective, which is not always the lowest strength </li></ul><ul><li>For dressings, make sure the size is there (and check that it is in part 2) </li></ul>
  12. 12. Pack <ul><li>For part 7, this is needed if more than one pack. The default is to the pack nearest to 100 units </li></ul><ul><li>The standard form has a location in the right-hand column of four small boxes. This is for pack size only in units. </li></ul><ul><li>ALWAYS USE A BLACK PEN </li></ul><ul><li>Always fill in the boxes from the left </li></ul>
  13. 13. Quantity <ul><li>This is mandatory for correct payment </li></ul><ul><li>Computer will default to 5 days’ supply or the smallest unbreakable pack </li></ul><ul><li>If you have to fill this in, get the prescriber to initial the quantity, or else the default will be taken </li></ul>
  14. 14. What else? <ul><li>If you have to obtain the item as a `special’, state the invoice price </li></ul><ul><li>Out of pocket expenses (including post & packing, and expensive phone calls) will be paid, but provide evidence </li></ul><ul><li>Measure & fit for hosiery & trusses </li></ul><ul><li>Additional paperwork for Oxygen </li></ul><ul><li>Any other pertinent data </li></ul>
  15. 15. SUMMARY <ul><li>PSD needs to know: </li></ul><ul><li>WHAT DID YOU GIVE? </li></ul><ul><li>WHAT QUANTITY DID YOU GIVE? </li></ul><ul><li>WHAT DID YOU PAY? </li></ul>
  16. 16. BROKEN BULK <ul><li>This is an allowance to claim for a full pack of an item that you may not use again </li></ul><ul><li>For example, if a new product comes in a pack of 100, but the prescription is for 30, you can claim the full pack </li></ul><ul><li>If a second form comes in within 6 months, it is assumed that you have used the same pack </li></ul>
  17. 17. HOW TO LOSE MONEY <ul><li>It is very difficult to make more money than you are entitled to from dispensing </li></ul><ul><li>It is relatively simple to lose money through poor communication </li></ul><ul><li>(It is also worth noting that about 70% of endorsements are either unnecessary or unhelpful. A large proportion of these come from endorsing programmes.) </li></ul>
  18. 18. Items not paid <ul><li>Non-tariff appliances </li></ul><ul><li>Blacklisted lines </li></ul><ul><li>Vaccines from the childhood immunisation programme </li></ul><ul><li>Also check that an item is legible </li></ul><ul><ul><li>“Can’t read”… </li></ul></ul>
  19. 19. Pack size errors <ul><li>Dressings are in single wrapped units. A box of ten dressings is counted as ten packs. PSD will not pick up this error </li></ul><ul><li>Enteral feeds are often shrink-wrapped into fours or sixes. State what you gave in terms on unbreakable containers e.g. 24 x 200ml (not 6 x 4) </li></ul>
  20. 20. Other defaults <ul><li>Urinary catheters </li></ul><ul><li>Formulation type default </li></ul><ul><li>Strength default </li></ul><ul><li>Pack size default </li></ul><ul><li>Quantity default </li></ul>
  21. 21. Prescription charges <ul><li>Only applies to FP10s now </li></ul><ul><li>PSD assumes that the charge is collected and deducts from payment </li></ul><ul><li>If prescription declaration is incomplete, it assumes that a charge is collected </li></ul>
  22. 22. Sources of information <ul><li>PSD web-site has some advice on endorsing and general prescription handling </li></ul><ul><li>Community Pharmacy Scotland also publishes advice, including recent errors and trends </li></ul><ul><li>National Pharmaceutical Association will also highlight any real issues </li></ul><ul><li>Most queries can be answered from the Drug Tariff on the web. </li></ul>