SmartClaim, Dispensing considerations

[Revised 23 May 2014]

Dispensing is carried out as usual, and nothing extra needs to be done.

Editing of scripts, or changes to the SmartClaim settings, can be carried out at any time up to the moment of claim preparation. The claim depends only on the state of affairs at time of preparation.

Phoned scripts and Held scripts will not be claimed and will be reported on the exception report in the period where the scripts were marked as phoned or held. ‘Unphoning’ or ‘unholding’ the scripts automatically adds the items to the next claim.

Once SmartClaim has been initialised, SmartClaim Claiming screens appear and a 'Claim' panel appears at the RHS of the dispensing and edit screens.

Dispensing

Units of dispensing -as a rule of thumb, always dispense in the basic units e.g. ml or g or unit. Refer to the unit displayed next to the quantity box of a rx if unsure. Units of dispensing are automatically adjusted at time of claiming to suit pricing office requirements. There are checks to ensure that it does not claim for 2 puffs instead of 2 inhalers.

Dispensing Insulin 3ml Penfills – The units of dispensing for insulin penfills are mls, but you can enter in the number of cartridges by entering in a ‘C’ after the quantity to denote cartridges. The computer will then translate the number of cartridges into mls. E.g. type in 1C for 1 cartridge , this will translate the quantity into 3mls; if you want 7 cartridges enter in 7C which will translate the quantity to 21ml.

Note: always dispense in the basic units e.g. ml or g or unit. Refer to the unit displayed next to the quantity box of a rx if unsure. Units of dispensing

Controlled drugs. If a 'starter pack' is used, dispense as an original and a repeat rather than an 'owe' to be paid dispensing fees on both.

Multiple repeats Selecting 'U = Unlimited repeats' automatically allows for up to 99 repeats.

MPSO and BSO If dispensed as instructed, SmartClaim claims for these as a supply order rather than a script.

Stat repeats Can be specified at time of dispensing the original, by editing before repeating, specified at time of repeating, or later after repeating but before claiming, or even after claiming by withdrawing the claim for the item and resubmitting. it.

Wastage Qty - Use to force a claim for the whole pack quantity eg 75ml from a 100ml reconstituted antibiotic is dispensed. See link to this topic.

'Claim' panel.

The 'Claim' panel at the RHS of the Dispensing and Edit screens shows the claim status of the item. It does not need to be referred to in normal use, but allows manual over-rides for unusual situations.

Don't Claim Use to manually suppress a claim for an item that would be normally claimable, e.g. a script for a foreign tourist where the operator forgot to mark the patient category as 'NSS' at the time.

NSS Claim Regardless - Flag this to force a claim of the original script of an NSS item for which a special authority approval has been applied for and may be available for subsequent repeats. The script is sent with an ‘I’ transaction code. Note: This original script has to be submitted in a separate claim from the repeats.

Claim regardless Use to force a claim of an item which is normally not claimable. The script will be sent with an 'N' transaction code. It is rare to have to use this. Please call the HealthSoft Support desk before using this option.

Cancel HBL Payment and Price again - Use to resend an already paid script for repricing if there has been a change in dispensing details such as quantity and number of repeats. Script is sent with a ‘C’ & ‘R’ transaction code.

Resubmit Script not yet Paid - Use to resend an unpaid errored script. Script is sent with an ‘I’ transaction code.

Reverse payment on Rx- Withdraws (reverses) an item already claimed and paid for. Script is sent with a ‘R’transaction code.