Schemes are a complex and vital part of the day-to-day work of Community Pharmacy. As such, TouchStore dispensary systems need to provide functionality for pharmacies to control how Schemes are implemented within their system.
Below you will find all the information you need in order to configure your Schemes as needed.
General Scheme Configuration
In order to view your list of Schemes, you will need to open the Rx 365 Back Office and navigate to the Config module.
Here the menu on the left-hand side will give you the option for Schemes. Click this and you will be brought to the Schemes page which will list all of the Schemes currently set up on your system.
You will see:
- Name
- Scheme Shortname
- Scheme Type
From this screen you can:
- Edit an existing Scheme by clicking the pencil icon
- Delete an existing Scheme by clicking the trash can icon
- Create a new Scheme by clicking + Add a new Scheme
.
Key Configuration Settings for Schemes
There is a lot of information about Schemes that is either hardcoded in the system or should not be changed as it relates to reimbursement of a public Scheme e.g. General Medical Services.
The best way to think about Schemes is in terms of PRIVATE vs PUBLIC.
A PRIVATE scheme is like Drug Refund where the patient pays full price for the products along with any fees and markup you decide to charge them in order to maintain a profitable business. Since dispenses under these schemes will not be claimed for reimbursement from the PCRS, you are free to decide on the charges presented to patients.
A PUBLIC scheme is like General Medical Services. Here patients only pay a set amount per month for items dispensed under this scheme and there are specific rules around the reimbursement of these dispenses by the PCRS. Other public schemes have different rules around pricing and reimbursement. The implementation of the rules in the dispensary system is managed by TouchStore. There are, however, some other configuration settings you may wish to change.
The key configuration settings for Schemes that you may be interested in are:
- Pricing
- Dispensing Fees
- Markup
- Printing
- UCF Receipt options
- Label options
- Other
- Auto-populate
- Repeat settings
- Prescription Validity settings
- Handling Loans
Claiming Method
Public schemes are further divided into the way in which dispenses under them are claimed for reimbursement.
There are two methods:
- Electronic
- Manual
- Electronic Claiming
Electronic Claiming of Schemes is done via the PCRS web service and requires a Claiming Certificate issued by HSE PCRS. The TouchStore dispensary system uses this certificate to securely transmit your claim file to the PCRS.
The following schemes are eligible for Electronic Claiming as of APRIL 2020:
- Drugs Payment Scheme
- General Medical Services
- GMS Repeat
- Health Amendment
- High Tech Medicines
- Hospital Emergency
- Long Term Illness
- Stock Order Scheme
- Manual Claiming
Manual Claiming of Schemes is done by presenting all of the relevant paperwork to the PCRS.
The following schemes are eligible for Manual Claiming as of APRIL 2020:
- EU National Scheme
- GMS Dental
- Hardship Scheme
- Methadone Scheme
- Psychiatric Scheme A6/7
- Veterinary Prescription
Default Schemes
The following schemes are included in the system by default:
| Scheme Name | Claiming Method |
|---|---|
| Drug Refund | PRIVATE |
| Drugs Payment Scheme | PUBLIC |
| General Medical Services | PUBLIC |
| GMS Repeat | PUBLIC |
| Health Amendment | PUBLIC |
| High Tech Medicines | PUBLIC |
| Hospital Emergency | PUBLIC |
| Long Term Illness | PUBLIC |
| Stock Order Scheme | PUBLIC |
| EU National Scheme | PUBLIC |
| GMS Dental | PUBLIC |
| Hardship Scheme | PUBLIC |
| Methadone Scheme | PUBLIC |
| Psychiatric Scheme A6/7 | PUBLIC |
| Veterinary Prescription | PUBLIC |
Edit an existing Scheme
If you wish to make changes to any of the settings for your Schemes:
- Navigate to the Config module
- Click Schemes from the left-hand menu to open the Schemes page
- Locate the Scheme you wish to edit and click the pencil icon beside it
You will now be shown the scheme maintenance screen which has various sections of settings that you can change.
The tables below detail the various settings and what they control.
- Local Scheme Settings
| Setting | Setting Type | Description |
|---|---|---|
| Max Repeats | Text Box | This setting is used when pressing Insert in the dispensing application to automatically set the Maximum Repeats available for a script. Once all repeats have been used up, the next Repeat of the script will create a new prescription record in the system. |
| Valid For | Text Box | This setting is used when pressing Insert in the dispensing application to automatically set the Valid Until for the script. Once the Valid Until date has passed, any Repeat of the script will create a new prescription record in the system. |
| Barcode Prefix | Text Box | This setting is used if you need to prepend up to 3 specific digits to the barcode of a Bag Label to tell your Retail system what Scheme is being scanned. The system will take the entered digits, add on 0's, embed the total price of the dispensings and append the check digit to make a 13-digit barcode to be printed on the Bag Label. |
| Permitted Drug Type | Dropdown Option | This setting is used to control what types of products are allowed to be dispensed under this Scheme. |
| Payment Type | Dropdown Option | This setting determines whether Scheme is a Public or Private scheme. Patient is for a Private scheme where the Pharmacy is being paid by the patient only. Authority is for a Public scheme where the Pharmacy is being reimbursed by HSE/PCRS. |
| Loan Type | Dropdown Option | This setting controls whether this scheme will have access to the Emergency Supply option in the Current Dispense screen or the On Loan option. |
| Card reference required | Check Box | This setting controls whether this Scheme will insist that a Card Reference e.g. Card No. is added against it in the patient's Edit F3 section. |
| Scheme expiry required | Check Box | This setting controls whether this Scheme will insist that scheme expiry details e.g. Year / Month are added against it in the patient's Edit F3 section. |
| GMS doctor required | Check Box | This setting is used when dispensing items under this Scheme and determines whether the GMS Doctor assigned to the script is required to have a valid GMS Number. |
| Split script on date | Check Box | This will split scripts to new form numbers based on the prescribed date. |
| Auto populate the scheme | Check Box | This setting is used when creating a new patient record and automatically adds this Scheme to the patient's Edit F3. |
| Show form number | Check Box | This setting is used when completing a dispense and controls whether the form number will display on the screen after completion. |
| This scheme is active | Check Box | This setting controls whether this Scheme is in use in the system. |
- Claim Settings
Claim Type
| Setting | Setting Type | Description |
|---|---|---|
| Claim Form Type | Dropdown Option | This setting is maintained by TouchStore and can be ignored. |
| Authority Type | Dropdown Option | This determines whether this Scheme is a public Scheme claimable via Electronic submission to the PCRS or whether it is a manually claimable scheme. < none > Manual Payments is also used for schemes that are not reimbursable. |
Validation Checks
| Setting | Setting Type | Description |
|---|---|---|
| Check claim prescriber | Check Box | This setting controls whether the system will force a valid GMS Number for the Prescribing Doctor against a dispense under this scheme when using the Verify for Claiming function in the Claims Module. |
| Check claim product | Check Box | This setting controls whether the system will force a valid GMS Number for a dispense under this scheme when using the Verify for Claiming function in the Claims Module. |
| Check patient reference | Check Box | This setting controls whether the system will force a valid Card Reference for the patient when using the Verify for Claiming function in the Claims Module for dispenses under this scheme. |
| Claim full owings | Check Box | This setting is maintained by TouchStore and can be ignored. |
- Print Settings
Receipt Options
| Setting | Setting Type | Description |
|---|---|---|
| Receipt Comment | Dropdown Option | This setting controls the comment that is printed on the footer of the UCF Prescription Receipt. |
| Receipts To Print | Text Box | This setting controls how many UCF Prescription Receipts are automatically printed a new dispense is completed. |
| Print drug price | Check Box | This setting controls whether the individual drug prices are to be printed on the UCF Prescription Receipt for dispenses under this scheme. |
| Print total price | Check Box | This setting controls whether the total script price are to be printed on the UCF Prescription Receipt for dispenses under this scheme. |
Label Options
| Setting | Setting Type | Description |
|---|---|---|
| Print product advice | Check Box | This setting controls whether Product Advice Labels will print for products dispensed under this scheme that have Product Advice assigned to them. |
| Print bag label barcodes | Check Box | This setting controls whether the Bag Labels for dispenses under this scheme will include a barcode on them for scanning at an EPoS system. |
- Scheme Pricing
Dispense Fees
| Setting | Setting Type | Description |
|---|---|---|
| Standard | Text Box | This specifies the Dispense Fee applied to dispenses under this Scheme that are not subject to any of the other fees shown below. |
| Phase | Text Box | This specifies the additional fees that are added for items that are dispensed in a phased manner. |
| Not Dispensed | Text Box | This specifies the Dispense Fee applied to dispenses of items under this scheme that are not provided to the patient and will be marked / claimed as Not Dispensed items. |
| Extemporaneous | Text Box | This specifies the Dispense Fee applied to dispenses of Extemporaneous products under this Scheme. _N.B. this applies to dispenses with a GMS Number beginning with 90, 91, 92 or 99. |
| Supervision | Text Box | This specifices the values of the Supervision Fee that will be added alongside the Dispensing Fee to any supervised dispenses under this Scheme. |
| Controlled Drug | Text Box | This specifies the value of the Dispensing Fee applied to dispenses of Controlled Drugs under this scheme. N.B. this will apply to any items with a Poison Code beginning with CD. |
| Patient Care | Text Box | This specifies what fee, if any, is used for the High Tech Patient Care Fee for this scheme. This setting is only relevant for the High Tech Scheme. |
| Markup Rate | Dropdown Option | This specifies the Markup Rate to be applied to the Cost Price of an item dispense under this scheme. |
| Apply GMS Levy | Check Box | This setting controls whether all products dispensed under this Scheme attract the GMS Levy or not. |
| Override price points | Check Box | If a product dispensed under this Scheme has a Price Point set up against it, this setting determines whether the Dispense Fee and Markup Rate specified in the Price Point is used or if the Scheme settings take precedence instead. |
Reference Pricing
| Setting | Setting Type | Description |
|---|---|---|
| Base Supplement Price | Dropdown Option | This setting controls how the dispensary system will calculate what the Supplement Amount for a Reference Priced product will be when the product is not being substituted. The calculation will always be the difference between the Reference Price for the product and whatever setting is chosen here. |
| Base Reference Price | Dropdown Option | This setting controls how the dispensary system will calculate what the Reference Price for a Reference Priced product should be based on when the product is not being substituted. |
| Apply reference pricing | Check Box | This setting controls whether Reference Pricing will be used when dispensing products under this scheme. If this is unchecked, Reference Priced items will be treated like non-Reference Priced items when dispensed under this scheme. |
| Force supplement | Check Box | This setting controls whether the system will automatically mark Reference Priced dispenses under this scheme as Force Supplement which will add a Supplement Amount to Reference Priced items dispensed under this Scheme, if Reference Pricing is enabled. |
Once you are happy with the settings you have applied, simply click Save Details to update your scheme.
Delete an existing Scheme
N.B. do not delete any of the Default Schemes in the system. See the list above for more information.
If you wish to delete one of your custom schemes you can use the trash can button in the Config module on the Schemes page.
Create a new Scheme
If you wish to create a custom scheme of your own you can use the + Add a new Scheme button in the Config module on the Schemes page.
When creating the scheme you will be asked to fill out three pieces of information first:
- Name: the descriptive name for the Scheme e.g. "Nursing Home Scheme"
- Scheme Shortname: the 2 letter short code for the Scheme. This will be used in the dispensary system as part of the form number e.g. "NH2003/0045"
- Scheme Type: this defines whether the scheme is for human prescribing, veterinary prescribing or both.
Once you have entered these details click Save. The scheme will then be created and you will have the opportunity to configure various other scheme settings.
Please see the Edit an Existing Scheme section for more information on the various settings available when your Scheme has been created.