How to Validate Scripts for Claiming

• Select the Claims option under Modules

• The main summary screen will be displayed
• Select the Claim Period that you wish to claim for

• A total of all scripts that have been dispensed under each scheme will be displayed under Not Validated
• Press the Not Validated tab to begin validating the scripts
• Select the scheme you would like to validate first

• On this screen you will see a listing of all scripts for the currently selected scheme

  Note - A script on loan will not go through claims, the script must first be repeated then claimed.

• Check each script to ensure all items have the correct patient reference, date, scheme, doctor and product gms number.
• Tick Validated for each script that you have validated. If you want to return to a script that isn't validated tick Query

Tip: Use the spacebar to mark scripts as validated and move to the next form

• Tick each script that has been validated
• If you have bulk validated them, tick Validate All button
• Press Apply

• All scripts under the selected scheme will move to the Validated tab.

• For a High Tech validation, the amount for a claim will sometimes display a minus sign this can be ignored the correct amount will still be claimed when sent.

How to Quickly Edit Patient Card or Doctor

• To change the patient reference quickly, select the script and press Edit Patient Ref
• The existing patient reference will be displayed
• Enter in the new patient reference and press Ok

• To change the doctor quickly, select the script and press Edit GMS Doctor
• The existing doctor will be displayed
• Enter in the new doctor and press Ok

How to View Previous Claims

• To view your previous claims click on the claimed tab highlighted below

• Once claimed has been clicked the screen will display the following options to filter claims
• Claim Period - You can select which month to display the claims for
• Schemes - this allows you to select what scheme to display claims for
• Claim Authority - this allows you to select which claim authority to display claims for
• Form Search - this allows you to filter claimed by a specific form number

• All claims will be displayed below for any based on whatever filters are selected, as shown below

  

• Each claim will display

• The Patient name
• The Patient Reference
• The script form number
• The scheme
• The prescriber
• The GMS number
• The amount
• The errors
• The Status of the claim
• Clicking on a claim will display the details of that script
• Clicking Select Patient will bring up the patients PMR screen.

Claim Status Letters

Letter, Status & Details

• | N | Not Validated | The item is in the Not Validated tab in the Claims module, awaiting validation by the user.

• | V | Validated | The item is in the Validated tab in the Claims module, awaiting verification checks by the system.

• | E | Exceptions | The item is in the Claim Exceptions tab in the Claims module, awaiting editing/fixing by the user.

• | C | Ready To Claim | The item is in the Send Claim tab in the Claims module, awaiting transmission to the PCRS.

• | P | Paid | The item has been sent to the PCRS and has not yet received an Exception response. As such, we assume it will be paid for unless the system is told otherwise.

• | D | Deleted | The item has been deleted from the Claims Exceptions tab as it was rejected by the PCRS and then deleted manually by the user, presumably because they opted not to pursue a further reclaim for the item.

How to Quickly Edit Other Script Information

• If you need to change other information, select the script and press Edit Script
• This option is available from both the Not Validated screen and the Validated screen.

• This will take you to the dispense screen for that script
• Edit the information and press re-complete to return to the claims module

How to Verify Scripts After Validation

• Press the Validated tab and ensure you are still on the expected scheme
• All scripts should be ticked
• Press Verify for Claiming

• Once you press Verify for Claiming all scripts will be verified by TouchstoreRx for the selected scheme
• If there are errors in any scripts that have been verified TouchstoreRx will display the errors.

How to Resolve Script Errors That TouchstoreRx Have Identified

• When you press Verify for Claiming all scripts will be verified by TouchstoreRx for the selected scheme.
• If there are errors in any scripts that have been verified TouchstoreRx will display the following screen detailing the errors:

• If the following column is ticked:

  • Prescriber No: the GMS Number is missing or invalid for the Prescriber
  • Open the Patient maintenance screen, double click on the Prescriber's dropdown list and find the doctor in question. Enter the GMS code for the prescriber.
  • Alternatively, if an incorrect Doctor has been selected for the script, Edit the dispense and change the GMS Doctor assigned to the script.
  • Product No: the GMS Number is missing or invalid for the Product
  • Edit the script highlighted and either select a different product that has a GMS code or enter a GMS code for the product.
  • Patient Ref: the Scheme Reference Number for the affected patient is missing or incorrect
  • The Patient reference (their scheme card number) is entered on the Patient maintenance screen.
  • The PCRS online Card checker can be used to verify the patient reference or contacting the PCRS directly.
  • Dupl. Scheme: the affected patient has more than one of the same Scheme on their Edit (F3) screen
  • Open the Patient’s file and open the Patient maintenance screen, Select the duplicate scheme and click the ‘Deleted Scheme’ button
  • Form Number: the Form Number is missing or invalid
  • Not Disp Reason: the Not Dispensed reason is missing or invalid
  • Qty: the Dispensed Quantity is missing or invalid. Quantity needs to be non-zero unless the item is Not Dispensed and must be greater than zero
  • Repeat Part Error: the Repeats Made or the Maximum Repeats information is missing or invalid
  • Amount Error: the Total Cost is missing or incorrect. If the Total Cost of an item is 0.00 you will see this error.
  • Edit the script and correct the Cost Price or select another product with an amount assigned.
  • Extemp Item: the item is marked as an Extemp Item but does not have the correct GMS Number. GMS Numbers for Extemp items must begin with 99 e.g. 99189.

• Once all scripts are fixed they can be verified again by ticking the scripts and pressing Verify for Claiming.

• All scripts will now move to Send Claim tab.
• Any Errors returned by the PCRS should be followed up with the PCRS

How TouchstoreRx Manages Under and Over Copayment for DPS Scheme

• Once the DPS threshold is reached for a patient all scripts are marked for claiming.
• If a patient does not reach the DPS threshold, scripts will not be marked for claiming.
• Validation happens normally for DPS. See How to Validate Scripts For Claiming

• When all scripts are Validated, TouchstoreRx separates Under and Over Copayment depending on whether they have reached the DPS threshold.

  Note: To be eligible for FEMPI family Over Copayment the family need to hit 134 to be added.

• By Default only Over Copayment will be displayed on the Validated tab under the DPS scheme.

• You can view all scripts that are under Copayment by pressing Under Copayment.

• If you wish to send any under copayment scripts in the claim you can select the script and press Mark Can Claim.

• These scripts will then move to the Over Copayment section.
• Press Over Copayment to return to the over copayment scripts that will be claimed.

How to Prepare and Send Your Claim

• Select the Claims option under Modules

• The main summary screen will be displayed
• Select the Claim Period that you want to prepare

• The total of all scripts for all schemes should be displayed under the Send Claim tab
• If not, follow the steps in How to Validate Scripts For Claiming
• Ensure the total of scripts under the Send Claim tab are correct and then press the Send Claim button
• During the claim period, the Send Claim button will appear.
• Once happy that all scripts are under Send Claim tab press Send Claim button.
• The following screen will be displayed for you to confirm the total number of scripts under each scheme:

• Press Ok to send the claim.
• The following confirmation is received from the PCRS and displayed on the screen:

  File Loaded Successfully: 30000_20080400.zip:
  
  File Size: 1501 bytes:
  
  No Claims in the file: 3
  

How to Fix and Re-send Claim Exceptions ( Reclaims )

  Note - you must be on the claims machine to check and send claim exceptions

• Select the Claims option under Modules

• The main summary screen will be displayed
• Select the Claim Period

• Press the Claim Exceptions tab

• Select the scheme you want to check for claim exceptions
• If you want all schemes displayed select All
• Press the Check button
• TouchstoreRx will check for any claim exceptions

Note: Claim exceptions can be checked for and re-claimed as many times as necessary for the first 8 working days of the month. After that, claim exceptions that have been fixed need to be sent with next month's claim.

• If there are no claim exceptions the following message will appear:

• If there are claim exceptions they will appear as follows

• If there is an issue with the script (i.e patient card invalid for this script) the error will appear in the top section
• If there is an issue with a specific drug on that script (i.e insufficient reason for a not dispensed drug) the error will appear in the bottom section
• When you select a script in the top section the drugs attached to that script will appear in the bottom section

• Select the script that you are fixing, read the error message and resolve the errors.

• To edit the exception of a claim, select the script and press Edit Script

• This will bring up the scripts dispense screen with limited options

• To remove an item from claiming, edit the script, select the item to delete, change its scheme type to Drug Refund this will remove it from claiming.

• Once you have resolved the errors, mark the scripts as fixed.

• Press Re-Claim

To Un-Validate a Script:

• From the PMR Console, click Modules and select Claims
• Hit Alt & V to open the Validated tab or Click on the Validated tab
• Hit Alt & H to select the scheme to Validated. Note: If the scripts to be validated are for a different claim period, Hit Alt & I to change the Claim Period
• Select the script to be un-Validated and Hit Spacebar. The selected script will be un-Validated and the next script selected

• Hit Alt & A to apply/save your changes

To Mark a Prescription as Having a Query:

• Marking a script as having a Query will ensure it stays on the Not Validated list

  • Select the script that you have an enquiry to make before Validation
  • Click on the Query checkbox to mark a script as having a query

The marked script will now stay on the Not Validated tab until un-marked as having a query.

---

• To Un-Mark a script as having a Query:

  • Select the script that you have an enquiry to make before Validation
  • Click on the Query checkbox to mark a script as having a query

The marked script can now be validated for claiming.

To Retrieve the Final File:

• From the PMR click Modules and select Claims
• Click on the Claim Exceptions tab
• Click the Check button
• TouchStore Rx will begin to download the Final file from the GMS

• Once complete, the scripts marked as paid in the Final file will be marked as Paid on the Claimed tab

• Note: Once the Final File is downloaded, it is NOT possible to process any more Rejected claims in that month. However, any rejected scripts remaining can be claimed in the following months claim.

To Claim a Continuing Care Fee for Hi-Tec Patients:

• Select the patient's record as normal
• Select the last Hi-Tec dispense for the patient
• Repeat the Dispense
• Click 'Not Dispensed', or Hit Alt & T
• Enter a Not Dispensed reason
• Edit the GMS No., replace with "88999"
• If there is more than one item dispensed, replace the GMS No. for each item

• Complete the dispense as normal.

• In the Claims module:

  • Validate and Verify the dispense as normal

FAQ's - How Do I Process my DPS Claims with FEMPI

Special Note: 
In your first month with the FEMPI enabled the version of TouchStore Rx, ALL DP Scripts dispensed prior to the upgrade WILL be marked as Can Claim.

Why? Prior to your upgrade, DP scripts are calculated as normal using the IPU Trade price and pre-FEMPI pricing schedule. As such, TouchStore Rx does not have the PCRS reimbursement value to calculate the FEMPI value of the script. Therefore, we must set ALL DP Script as Can Claim – for the first month. Any DP dispenses completed after your upgrade - to the FEMPI enabled version - will have the Can Claim flag determined using the PCRS reimbursement price (see questions below for more info).

N.B. Be aware: Please be careful of DP families who have scripts dispensed both before the upgrade and after the upgrade for the same claim period. As dispenses completed prior to the FEMPI upgrade, will not have a FEMPI Total available on the script record, TouchStore Rx may determine the Can Claim flag incorrectly. These forms may need to be manually marked for claiming.

What Do I Need to Do to Separate my DPS Scripts Under the Co-Payment Threshold Before Clicking Verify for Claiming?

Nothing. TouchStore Rx automatically separates DPS scripts per family, for claiming at the time of dispense. As you complete each DPS Script, TouchStore Rx calculates the FEMPI family total. If the FEMPI Family total is under the co-payment threshold, the Can Claim flag is set to FALSE for all script records for that family, for the current month.

If the FEMPI Family total is over the co-payment threshold, the Can Claim flag is set to TRUE for all script records for that family, for the current month. After you have validated all DPS Scripts for the current month, you can simply click 'Verify for Claiming' as before.

Note: As always, please check that all script records have been entered and validated correctly. An incorrect entry can result in the Can Claim flag being set incorrectly.

How Do I Get a List of Forms That Are Under the Co-Payment Threshold to Remove Those Forms from my Claim Bundle?

How Do I Remove the Below Threshold Paperwork (DPS Forms / Unified Claim Form Receipts) From Claims Bundle Before Posting to the PCRS?

How can I view forms that are under the co-payment threshold?

• Open the claims module
• Select the month being claimed for
• Open the Validate tab for the DPS Scheme
• Click the "Under Co-pay" button

TouchStore Rx will now display all forms that are calculated as being under the co-payment threshold. These forms can be removed from the DPS form bundle before posting to be PCRS.

How Can I View Forms That Are Over the Co-Payment Threshold?

By default, TouchStore Rx will always display DPS Scripts that are over the co-payment threshold.

If you have previously clicked the "Under Co-Pay" button, and TouchStore Rx is displaying forms under the co-payment threshold;

• Open the claims module
• Select the month being claimed for
• Open the Validate tab for the DPS Scheme
• Click the "Over Copay" button

TouchStore Rx will now display all forms that are calculated as being over the co-payment threshold.

Do I Need to Calculate FEMPI Values?

Do I Need to Click the Calculate FEMPI Button at the Top of the Claims Module Before Claiming / Separating DPS Scripts?

Short answer, no. TouchStore Rx automatically calculates the FEMPI value of ALL scripts at the time of dispense, and for DPS scripts, determines if the family is above or below the threshold. The Calculate FEMPI button allows users to re-calculate the default Dispensing fee allocated at the time of dispense. As the FEMPI regulations have introduced a sliding scale dispensing fee, based on the number of items dispensed during the month, TouchStore Rx must use a default dispensing fee value for calculating FEMPI script values during the month, as the total number of items dispensed for the month, is not known until the end of the month.

The Calculate FEMPI button can be clicked at any time to re-determine the likely dispensing Fee to be allocated to a given dispense. Allows users to view the estimated claim value of scripts dispensed to date. The Calculate FEMPI function is automatically run when you click the “Send Claim” button, so there are no additional steps when submitting your claim.

How Can I View the FEMPI Family Total?

To view the FEMPI Family value of all scripts dispensed to a selected family;

• Open the claims module on the Validate tab, or select one patient's file, from that family
• From the PMR Console, or the Validate tab in the claims module, Hit F5
• This opens the standard “F5 DPS Analysis screen”

A new “FEMPI Family Total” text box has been added to the top of this screen.

How Can I Set as Form as Claimable? How Can I Manually Set as Form to be Claimed?

To set a form that is currently flagged as Can Claim FALSE to Can Claim TRUE;

• Highlight the script record on the validated tab of the claims module
• Click the "Set Can Claim" button
• TouchStore Rx will change the Can Claim flag to TRUE
• The validated tab scripts grid will refresh and the script record will disappear

Click the "Over CoPay" button, to confirm that the record is now set to be claimed.

How Can I Set as Form as NOT Claimable? How Can I Manually Set as Form to NOT be Claimed?

To set a form that is currently flagged as Can Claim TRUE to Can Claim FALSE;

• Highlight the script record on the validated tab of the claims module
• Click the "Set Can Claim" button
• TouchStore Rx will change the Can Claim flag to FALSE
• The validated tab scripts grid will refresh and the script record will disappear

Click the "Under Co-Pay" button, to confirm that the record is now set NOT to be claimed.

Form Number Format

Example: GM1806/0056

• GM: The scheme shortname, GM = General Medical Services, must always be two characters only
• 18: The year the script is being claimed for, must always be two digits only
• 06: The month the script is being claimed for must always be two digits only, includes leading zeroes where applicable e.g. 01-09
• /: this separates the scheme and date information from the Sequence number
• 0056: The Sequence number, this tells you this script was the 56th script for this scheme in this month and year. Must always be four digits only, includes leading zeroes where applicable e.g. 0001-0999

N.B. the FORM NUMBER only controls which Claim Period the items will be sent in and is not strictly tied to the Dispense Date. It is also not reviewed by the PCRS to check whether items are being dispensed at least 28 days apart either, this is handled by the PCRS looking at the Dispense Date, not the Form Number.

E.G. You can have a GM item dispensed on 23rd March 2019 and it may receive a Form Number such as GM1903/0045. If you do not transmit it in your MARCH Claim you can change the Form Number to any subsequent claim month, e.g. APRIL or MAY and then send it in that month. The Dispense Date will remain the same and the PCRS will reimburse you if the Claim is valid based on the Dispense Date.

Claiming for High Tech Not Dispensed Fee (Patient Care Fee)

As part of providing the service of dispensing High Tech drugs to the patient, pharmacies are eligible to claim a High Tech Care fee, also known as a Patient Care Fee for handling these products for patients.

Pharmacies can claim a Patient Care Fee in the following circumstances:

• The same month a High Tech Drug is dispensed.
  • This is claimed normally by dispensing the item and sending it in the Claim.
  • This will give you the full Patient Care Fee (approx €63.52)
• In the 1st month after a High Tech drug has last been dispensed and is not being dispensed this month.
  • This is claimed by dispensing the drug and marking it as Not Dispensed and giving it the relevant Not Dispensed Reason.
  • This will give you the full Patient Care Fee (approx €63.52)
• In the 2nd month after a High Tech drug has last been dispensed and is not being dispensed this month.
  • This is claimed by dispensing the drug and marking it as Not Dispensed and giving it the relevant Not Dispensed Reason.
  • This will give you HALF of the Patient Care Fee (approx €31.76)
• In the 3rd month after a High Tech drug has last been dispensed and is not being dispensed this month.
  • This is claimed by dispensing the drug and marking it as Not Dispensed and giving it the relevant Not Dispensed Reason.
  • This will give you HALF of the Patient Care Fee (approx €31.76)

It may also be necessary for you to amend the GMS Number against your dispense to a GMS Number beginning with 88xxx. please check with the HSE/PCRS on this if you are unsure what GMS Number should be placed against the dispense in order to correctly claim the Patient Care Fee for the item in question.

No Send Claim Button

If you are in the Send Claim tab in the Claims module and there is no Send Claim button, please ensure you are on your Claiming PC. You will not be able to send your Claim on any other RX PC

How to see a list of all previously sent Claims

There are two places to find a listing of items previously sent in a Claim:

• DataViewer
• Claims Module -> Claimed Tab

DataViewer

Dispensing -> Claimed Items report. Run it for the month in which you want to see the items for e.g. looking at items claimed on 1st March 2019, run the report from 01/03/2019 to 31/03/2019.

Claimed Tab

In TouchStore Rx, in the Claims module, the Claimed tab will list all of the scripts and items sent in a Claim for a given period.

In the top left of the screen, you can choose which Claim period to look at. Just below that you can choose which Scheme you would like to look at.

In the top half of the screen, you will see a listing of all of the scripts that were sent. In the bottom half of the screen, you will see the listing of items within a script that you have highlighted in the top half.

In the middle of the screen on the left-hand-side, you can see a count of the number of scripts sent in the selected Claim period for the select Scheme. This can be a handy way of getting the number of scripts per scheme that were sent in a given Claim Period.

Claim Exception Reasons and what to do with them

N.B. once a customer had made a change to the system e.g. changed Rx Type against a doctor, changed a patient's Scheme Reference / Card No. etc... this information will then be sent when the customer reclaims for the items.

Exception Reason & What to Do?

• Incorrect Claim Version Number | When you send a Claim for an item to the PCRS you send a Version Number to them to track how many times this item in this script for this patient has been sent to the PCRS. If the item is rejected and is then reclaimed the Version Number will increase. Sometimes the PCRS do not send us back the correct Version Number. I.E. the item is on v1.3 as it has gone over and back 3 times but the PCRS send back v1.1. This means when you send it back to them you will send v1.2. Since they will be expecting v1.3 they will reject it again. Simply sending it again will normally resolve the issue, however, it may take a few transmissions for it to catch up with the correct Version Number. |

N.B. Claim Exceptions can only be RECLAIMED for during the RECLAIM PERIOD in the month they were rejected. e.g. it is April 2nd 2019, you have sent your MARCH 2019 claim and you are dealing with your claim exceptions. You have a Claim Exception for a script from DECEMBER 2018 and a Claim Exception for a script from MARCH 2019. You will be able to edit and fix any Claim Exceptions and you can push them into the Send Claim tab however ONLY the MARCH 2019 script will be reclaimed when you hit Send Reclaim in the Send Claim tab to reclaim your rejected items after fixing them. The DECEMBER 2018 script will stay in the Send Claim tab until it comes time to send your next FULL claim i.e. the APRIL 2019 claim and will be reclaimed then.

If you are in the Send Claim tab in the Claims module and there is no Send Claim button, please ensure you are on your Claiming PC. They will not be able to send their Claim on any other RX PC

If you are in the Send Claim tab in the Claims module and there is no Send Claim button, please ensure you are on your Claiming PC. They will not be able to send their Claim on any other RX PC

Stock Orders in TouchStore RX

A Stock Order is when a GP is dispensing items in bulk like needles, strips, etc... and also for limited drugs. This is commonly used for GP's living in remote areas who need to obtain medical supplied in bulk from a pharmacy. This type of dispensing can be claimed with the PCRS.

When a Stock Order is submitted for claiming to the PCRS but the doctor is not set up correctly with the relevant Slip Type, the script will be rejected as shown below

In order to set up a doctor correctly in TouchStore RX for Stock Orders, or to confirm correctly set up, please follow the steps below:

• open modules -> configuration

• Click the "Professional" tab at the top

• The Maintain Professionals window will open

• Search the name of the doctor you're looking for, then select that doctor and click the "edit" button.

• from this window you can edit the selected doctor

• In the bottom right-hand section of this screen is the dropdown box for the Rx Type. This is where we need to choose the relevant Slip Type for this Doctor's Stock Order

  • For non-dispensing Stock Order eg. swaps, test strips, syringes etc... you will need to set this to the RX Type 2 Pink Slip
  • For Dispensing Stock Orders containing drugs, you will need to set this to the Tx Type 1 White Slip

Once this setting has been applied, any Reclaims that have been rejected due to the Rx Type being set incorrectly can then be re-sent. This will then forward the correct information regarding these Stock Orders scripts to the PCRS.

Stock Orders

To claim for Stock Orders correctly in TouchStore Rx the following 3 things need to be true:

1. Dispenses are attached to a Patient file that has the Doctor in question set as their Prescribing Doctor AND their GMS Doctor
2. The Doctor in question is set up with the correct RX TYPE - the screenshot below
   • For NON-DISPENSING (swabs, test strips etc...) choose Rx Type 2 Pink Slip
   • For DISPENSING OF DRUGS choose Rx Type 1 White Slip
3. The Stock Order scheme Card No. in Edit (F3) is set to the correct value
   • The Card No. for a Stock Order scheme needs to be in the format of a GMS Card No. e.g. 7 Digits and a Letter "1234567A". In the TouchStore Rx system, this Card No. needs to contain the Professional's 5-Digit GMS number at the beginning followed by two digits and a letter. For example, a doctor with a GMS Number of 71502 should have a Stock Order Card No. of 7150299A. 99A can be any sequence of two digits followed by a letter.

Drugs Payment script(s) under €124 that shouldn't be

Drugs Payment Scripts use the FEMPI FAMILY TOTAL for a given patient/DPS family to determine whether the DP scripts for that patient/DPS family can be claimed for in a given month.

Until the FEMPI FAMILY TOTAL for a given patient/DPS family is AT or ABOVE €124, you will not be able to claim for ANY scripts dispensed to that patient/DPS family. They are effectively considered to be private patients while the FEMPI FAMILY TOTAL is below €124.

To see the FEMPI FAMILY TOTAL for a given patient/DPS family, use the F5 DPS Analysis and choose the month in the question from the dropdown in the top-left of the screen.

The FEMPI FAMILY TOTAL is a calculation and not simply a sum of the total prices of scripts etc... The following calculation is used to determine the FEMPI FAMILY TOTAL for each item in a script and this value is then totalled across all items for the month:

FFT = (IPU Cost Price * 0.92) + 5.00

We take the IPU Cost Price for an item, get 92% of that value, and then add on a flat €5 Dispense Fee.

E.G. 30 tablets of WARFARIN 1MG has an IPU Cost Price of €10.00. The FEMPI FAMILY TOTAL for a dispense of 30 x WARFARIN 1MG would be: (10.00 * 0.92) + 5 = 14.20

Please note, the above dispense of WARFARIN 1MG has a FEMPI FAMILY TOTAL of 14.20, the product itself has an IPU Cost Price of 10.00 but the actual price charged to the patient will be different as it will be subject to the Dispense Fee set in the Pharmacy along with the Markup Rate set in the pharmacy.

As such, a patient may end up paying something like €19.00 e.g. 10.00 Cost Price + 20% Markup Rate + 7.00 Dispense Fee but only 14.20 will contribute to the FEMPI FAMILY TOTAL.

This discrepancy between what the patient actually pays and the FEMPI FAMILY TOTAL (which controls whether scripts can be claimed for or not) is a common source of confusion for people as you can regularly end up in a situation where a patient has paid €124 to the pharmacy for their items but the FEMPI FAMILY TOTAL is well below €124.

Under / Over Copayment

TouchStore Rx automatically calculates the FEMPI FAMILY TOTAL against dispensed items. When it comes to Claiming, we know that patients/DPS families with a FEMPI FAMILY TOTAL below €124 cannot be claimed for. As such, in the Claims module, we prevent so-called "under copayment" scripts from moving forward into the Ready To Claim section.

We do this by separating DPS scripts in the Validated tab in the Claims module into scripts that are "Over Copayment" and scripts that are "Under Copayment". Only scripts in the "Over Copayment" section can be pushed into Ready To Claim to be sent at the end of month claim.

If a DPS script is not showing in the Claims module, try switching to the "Under Copayment" section to see if the script is showing there. If the script(s) show in that section then the FEMPI FAMILY TOTAL for that patient/DPS family is below €124. If you are unsure why this is the case you can go to the patient's PMR and view the F5 DPS Analysis screen to confirm the value of the FEMPI FAMILY TOTAL.

What to do when getting a new GMS Number

If you are being given a new GMS Number for your pharmacy, the following tasks will need to be completed:

• Request a new Claiming Certificate

• Confirm which Claims Period the new GMS Number is going to be effective from

  • e.g. if it's March 23rd and you advise you're getting a new GMS Number from 1st April - do you need to send all of MARCH dispenses under the NEW GMS Number or the OLD GMS Number?

• Install the Claiming Certificate following the instructions from the PCRS

Claiming for Phasing Fee for Nursing Homes

• For MDS dispenses, you can configure the Dosage System to include or exclude the Phasing Fee.

• You can do this by changing the Auto Phase setting. Turning this ON will phase the records and claim a Phasing Fee. Turning this OFF will not phase the records and will not claim a Phasing Fee.