Implementation of the Minor Ailment Service Produced by NES Pharmacy

Transcription

1 Implementation of the Minor Ailment Service Produced by NES Pharmacy Payment Processing

2 SECTION 4 Payment Processing NHS pharmacists in Scotland can apply for a printed copy of this pack, please contact: pharmacy@nes.scot.nhs.uk

3 The Minor Ailment Service Introduction - Page 1 This section looks at how to submit your CP2 forms for payment and how to track emas payments on your Practitioner Services payment schedule. Objectives At the end of this section you will be able to: outline the main steps involved in submitting your CP2 forms for payment processing complete your GP34 form describe how to track your MAS payments. Section Contents 4.1 Submitting Forms Pages Completing The GP34 Form Pages Capitation Payments Pages 4-5 Section Summary and Reflection Page 6

4 Page 2 - Submitting Forms Submitting Forms The Minor Ailment Service The Minor Ailment Service Completing The GP34 Form - Page Completing The GP34 Form As outlined earlier, all MAS CP2 registration, withdrawal and consultation forms should be submitted along with all the other prescription forms such as GP10s and included in the exempt part of your bi-monthly submission. They should be bundled separately i.e. all your CP registration forms together and all your CP consultation forms together. If you are required to use the manual A4 registration and CP1 forms you must also include them in the exempt part of your submission. The following information about CP2s should be included on your GP34 form (see Figure 8). CP2 registration and consultation (referral or advice only) forms: Count the form ONLY, e.g. form = 1 item = 0 CP2 consultation (treatment supplied) forms Count the form and the item(s), e.g. form = 1 item = 2 (if two items prescribed) These figures are recorded on the GP34 in the Exempt from Charges area ONE total for No of forms and ONE total for No of items do not split the counts and record separately. Figure 8: GP34 Form For general guidance on prescription sorting and GP34 declarations, see Pharmacy_Guidance.htm

5 Page 4 - Capitation Payments Capitation Payments The Minor Ailment Service The Minor Ailment Service Capitation Payments - Page 5 Withdrawn Lapsed At the end of each month PRS provides a MAS capitation count for each pharmacy to the DCVP payment system. The count is a snapshot taken at the cut off date which is the last calendar day of each month. The capitation count at the end of a given month is included in the same payment cycle as other pharmacy activity for that month, i.e. two months in arrears. For example, payment for the capitation count at the end of August is made at the end of October with payment for prescriptions dispensed in August. This is when a person is recorded on PRS as being withdrawn from a pharmacy and the following rules apply: This is when a person is recorded on PRS as being lapsed and the following rules apply: This information is reported on a PAY 006. It also details the number of additional, withdrawn and lapsed registrations for the corresponding months. Individual contractors can request a more detailed registration report from the epharmacy Customer Services Helpdesk. This report lists the details of the changes to your capitation payment by providing the CHI number details for each category. PRS records and reports on all MAS registrations and details them on a PAY 006. There is a more comprehensive monthly report detailing registrations, withdrawals and lapsings which you can request by contacting the epharmacy Customer Services Helpdesk. There are three status conditions for registration - registered, withdrawn and lapsed. These are described in more detail through the following text. Registered 2 For a person to be eligible for registration they must: be exempt from prescription charges be registered with a Scottish GP practice not be registered for MAS at more than one pharmacy at the same time. 3 There are a number of conditions which exclude people from registration: resident in a Care Home (Nursing or Residential Home) have a prepayment certificate their registration has lapsed (i.e. they have turned 16 or 18 or have not used the service within the previous year) 4 Under the registered status you can provide a MAS consultation. 1 They will be not included in your pharmacy s capitation count for that month. 2 For a person to be withdrawn one of the following circumstances applies: the person has requested to withdraw and the withdrawal process has been completed the person is no longer exempt from prescription charges the person has registered at another pharmacy the person has died the person is no longer registered with a Scottish GP practice the person has moved into a Care Home. The last four points are automatically identified by PRS and communicated to your pharmacy using the electronic messaging system. 3 Under this status you should not provide a MAS consultation. 4 Any withdrawn person who wishes to receive a MAS consultation must re-register. 1 The person is not included in your capitation count for that month. 2 A lapsed person differs from being not registered (never registered or withdrawn) because the person does NOT need to complete the registration process again in order to receive a MAS consultation. The consultation itself has the effect of unlapsing (re-registering) the person if they are still eligible for MAS from the date of the consultation. 3 A person will be lapsed automatically when they: have not participated in the service for 12 months (participate means receive a consultation) have turned 16 years of age have turned 19 years of age. 4 Under this status you can provide a MAS consultation if the person is eligible for MAS. The PAY 006 details the number of additional, withdrawn and lapsed registrations for the corresponding months. The more detailed registration report lists the details of the changes to your capitation payment by CHI number. REIMBURSEMENT PAYMENTS This is when a person is recorded on PRS as being registered at a pharmacy and the following rules apply: 1 They will be included in your pharmacy s capitation count for that month. Your PAY 001 schedule details your reimbursement payments for MAS items dispensed, including any adjustments made. You should review your PAY 001 schedule every month.

6 Section Summary and Reflection Summary Box all MAS CP2 registration, withdrawal and consultation forms should be submitted along with all other prescription forms such as GP10s in the exempt part of your bi-monthly submission any manual A4 registration and CP1 forms must also be included in the exempt part of your submission PRS records and reports on all MAS registrations on the PAY 006 schedule (a more comprehensive monthly report can be requested by contacting the epharmacy Customer Services Helpdesk) a person recorded on PRS as being withdrawn or lapsed from MAS in your pharmacy will not be included in your capitation count for that month the PAY 001 schedule details your reimbursement payments for MAS items dispensed, including any adjustments made MAS reports from PRS correspond with the same payment cycle as other pharmacy activity for that month i.e. two months in arrears a MAS consultation itself has the effect of unlapsing (re-registering) a person whose registration has lapsed (if still eligible for MAS), from the date of the consultation. Tracking Processes End of Reflection Box Who completes the bi-monthly GP34 submission in my pharmacy? Do they need further training on counting and entering figures for MAS forms? Where will I store completed MAS forms? Summary Reflection

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