Claims

The Claims module in the Back Office application shows you general information about your End of Month Claims submission to HSE PCRS. You can view previous months and check how the current month is going.

To access Claims, select the Claims module from the Home Screen

In the Claims module, the menu provides two options, Claims and Reclaims:

Claims Screen

In the Claims section you will see the following information:

In the top right of the screen, you choose the month you wish to view information for.

N.B. you will only be able to view information about End of Month Claims sent through TouchStore software

Here you can see if the claim has been SENT, if there were any ERRORS and if it is still NOT SENT. This is useful for the main pharmacist in a store if they are away from the pharmacy during the Claims period so that they can ensure that the claim is being handled correctly in their absence.

N.B. ERRORS refers to errors that appeared in the dispensary software when trying to send the claim. This may be due to invalid data in the claim file or due to transmission failure due to an issue on the HSE PCRS side. Please check the Local Rx Application for for more information.

You can also see the timestamp for when the Claim was sent, the No. Scripts sent and the Value of what was sent (as judged by the TouchStore system, applying known PCRS rules) and once the Final File has been downloaded you will be able to see the no. Scripts and the Value of what has been Paid by HSE PCRS.

You can also see information about whether there were Exceptions in the claim and if the Final File is Downloaded yet.

Reclaims Screen

The Reclaims Screen shows you information about any Reclaims that you have sent to HSE PCRS after receiving exceptions for your main Claim.

Here you can see if the Reclaim has been SENT or if there were ERRORS.

N.B. ERRORS refers to errors that appeared in the dispensary software when trying to send the claim. This may be due to invalid data in the claim file or due to transmission failure due to an issue on the HSE PCRS side. Please check the Local Rx Application for for more information.

You can also see the timestamp for when the Reclaim was sent, the No. Scripts Sent and the Value of what was sent (as judged by the TouchStore system, applying known PCRS rules) and whether any Exceptions have been received for that Reclaim.