[Revised Jan 01]
Warning: Initialising SmartClaim erases all previous claim records. It should only be used when switching it on for the first time, OR to erase old records deliberately in event of a change of ownership of the pharmacy.
Getting SmartClaim started before Initialising the claim
It is important to check that all prescriptions that have not arrived back into the pharmacy prior to the initialisation date to be ticked as phoned. This is to ensure that they will be claimable under the first electronic claim period.
For example: Phoned or faxed scripts that fall into the last manual claim period but are unable to be sent away with the last manual batch must therefore be claimed in the first electronic claim period. In order for the computer to recognise that these scripts are not currently held in the pharmacy and therefore unable to be sent away, it must first be ticked as phoned before initialisation. After initialistion, unphone these scripts and they will automatically be submitted in the first electronic claim period.
Controlled drug prescriptions.
Controlled drug scripts that are started in the manual claiming system but have repeats which fall into the electronic claim period must either be claimed fully manually or electronically. In order to do this simply tick the phoned option for all manual dispensing's done prior to the initialisation date. After initialisation, un-phone these scripts and they will be submitted in the first electronic claim period.
Close control scripts
These scripts which are sometimes held in pharmacy until the entire prescription is filled, will need to be sent off to 'HealthPac' before they have been fully dispensed. This is to ensure 'HealthPac' has an original script on file, and can now pay out electronically for its repeats.
Refer backs
Any manual scripts that have been referred back by 'HealthPac' on the last manual claim will need to be forced into the electronic claim. For instruction on how to do this, contact Healthsoft.
Initialising 'SmartClaim' for first use
1. Use the function to reset phoned scripts in bulk, so there are no outstanding phoned scripts. When phoned scripts are marked off as received, they are automatically added to the next SmartClaim and this is not wanted for scripts outstanding before the start of SmartClaiming.
2. From the RxOne Start Menu, Tools, Options screen, Switchboard tab.
3. Tick the 'SmartClaim Enabled' option. You will be prompted to enter your SmartClaim registration code - this will be sent with the setup pack or can be provided over the phone from HealthSoft, enter this and click OK.
4. A message will be displayed asking you if you wish to initialise claims for the first time. If this is the first time you are using claims, select Yes, otherwise select No.
If you selected Yes to initialise claims, you will be prompted to enter the start date for the current claim period. This should default to the correct date, but make sure you double check before proceeding. All claimable scripts which were done ON or AFTER the date entered here will be included in the next claim, and any scripts which were done prior to this date will not. SmartClaim can work retrospectively, so it is alright for it to do the whole of the current batch, even if initialised on the last day of the batch. If this date is correct, click OK and wait while the claims module is initialised, which is a once-only process can take anywhere from a few seconds to 30 minutes.
What data do you wish to release?
Claimable scripts are always claimed, but the user can decide whether to restrict or release two types of data. These can be changed at any time and the batch made up again in the new format.
Under s'net cutoff scripts. (Under 'SNCO' scripts) E.g. Is the computer to include details of a script for $12 for a $15 patient? Note that a $6 with 2 repeats is always claimed, as the original and both repeats must be claimed in order for $3 to be paid on the final repeat.
This can be turned on/off at any time by ticking/unticking the box but be careful not to alter the 'SmartClaim Enabled' option.
Claiming format
SmartClaim can prepare the data in either of the formats labelled;
"HFA" which as at Jan 2001 the 'Pronet 2.29' format.
Click in the option box as required. This can be changed at any time and the batch made up again in the new format.
Installation complete
SmartClaim is ready to use. Close down RxOne and restart, and you will notice a 'SmartClaim' or 'Direct Electronic Claims' button will have appeared on the Tools tab in the Pharmacy program Start Menu. In the dispensing and editing screens, a 'Claims' panel will have appeared at the RHS to allow manual over-ride of claiming.
Initialisation number fails?
If SmartClaim initialisation number fails, check the format of the gst # in User Details. It must be in the format xx-xxx-xxx . Other formats will allow RxOne to run but are not acceptable for Electronic Claims.
CDs, Narcotics
On SmartClaim, are handled the same as other drugs. Except that the original script form is retained for the CD regs.
'HealthPac'Related topic