Transcript PTP 16-17 Day 1 - Prescription Payment Support Services

Introduction
 About
Me
 Format Of Each Day
 What We Will Be
Covering
About Me
Who Am
I?
General

Employment
What Will We Be Covering ?
 How To Correctly and Effectively Batch
Prescription Forms For BSO
 How To Effectively Interpret The Drug
Tariff Month
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What Is Allowed ?
What Is Disallowed ?
Specials
Multiple Dispensing Fees
OOP Expenses
What Can We Do To Help
Each Other?

Be Open And Honest
 Respect Others Questions
 Listen (2 Way)
 Challenge Me If You Think I’m
Incorrect
 Tell Me If I Am Moving Through
The Subject Too Fast
The Drug Tariff
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What is it ?
Do I need it ?
When will I use it ?
What is in it ?
 The
Drug Tariff details the amount paid to
contractors for NHS services including both
reimbursement (i.e. the cost of drugs and
appliances supplied against an NHS prescription
form) and remuneration (i.e. professional fees
and allowances which are paid as part of the
NHS pharmacy contract). The Drug Tariff is
produced monthly by Business Services
Organisation (BSO).
The Northern Ireland Drug
Tariff
Rules
and Regulations for Payment
NI follows English Drug Tariff
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Drugs /Preparations
Appliances
ZD List
Dispensing Fees
Blacklist
Dispensing Fees
DPF/NPF
In The Beginning
Patient arrives with Prescription Form
How to determine if the product is
allowed on prescription (HS21R)
Firstly, the item needs to be identified as either a
medicinal product
or
a medical device (could be an appliance, liquid,
ointment, emollient, etc.
How Will I Know ?
The
easiest way to tell the difference is to
look for a CE mark which signifies that
the item is a medical device.
The CE mark can normally be found on
the packaging of a device, on the
instruction leaflet and on the device itself.
If there is a CE mark, it is a medical
device.
CE DEVICES

A
Mark on any item means it has been registered as a
device and not a medication

Any Item marked

Not all

There is NO

Before dispensing an item for the first time check if it has a
mark on it and check if it is listed in the Drug Tariff

Finding a code will ensure the item is allowed, if there is no
code then double check
must be listed in the Drug Tariff
items are allowed on prescription
List on the Drug Tariff
Yes It Is CE Marked
What Now ?
To be allowed on HS21R
CE Marked Device Must be listed On The
Drug Tariff Part XI a
The exact size must be on the drug tariff
Check if it is a CE Marked Device
Check If it is on the Drug Tariff
Flexitol Heel
balm 40g
D O Getwell
Look for code in BSO Code Book
1287/40
Code Prescription Form
Check if it is a CE Marked Device
Check If it is on the Drug Tariff
Flexitol Heel
balm
56g
This is Disallowed and will not be paid
You can explain to the patient that other sizes
are allowed and the GP may change the
prescription to another size
D O Getwell
NO CE Mark
If there is no CE mark, it is not a medical device,
therefore it is a medicinal product
Next, you need to check that the pharmacy is
allowed to dispense the product by checking
that it is not on the Blacklist, i.e., Part XI a of the
Drug Tariff . If it is not in the blacklist, then it is
allowed on an HS21R.
DISALLOWED CE MARKED
DEVICES
Actimist
Audiclean
Contact Lens Solutions
Flexitol Heel Balm 56g & 112g
Salcura Cream and Spray
Sterimar Spray 100ml
Neilmed Sinus Rinse
Hemocline
Histofreezer
Wartner
Scholl Wart and Verruca Remover
Biofreeze
(This list is not exhaustive)
The Blacklist
Any medicinal product not in the ‘Blacklist’ can
be prescribed /paid on the NHS
Butter is not on the Blacklist
Butter
1kg
Do not Dispense before confirming the following:
Speak to the GP. If the GP confirms that he definitely
prescribed this product, call BSO.
BSO will confirm that it is ok to dispense it and
advise
you to send a receipt for the product.
D O Getwell
Check with BSO, how they wish you to submit this
prescription & receipt.
Flora is on the Blacklist
Do not Dispense
Flora
1tub 250 gms
D O Getwell
This is Disallowed
When a prescription for a blacklisted product is received,
pharmacy staff should not dispense this item as it will not
be paid.
The patient may choose to return to the GP to have an
alternative medicinal product prescribed
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Fink Linusit Gold Pure Golden Linseeds
Flar Capsules
Flavelix Syrup
Flexcare Soft Lens Solution
Flexsol Solution
Flora Margarine
Floradix Formula Liquid
Floradix Tablets
Floral Arbour Tablets (Cathay)
Flucaps
Flunitrazepam Tablets 1 mg
Fluralar Capsules 15 mg
Fluralar Capsules 30 mg
Flurazepam Capsules 15 mg
Flurazepam Capsules 30 mg
Flurazepam Hydrochloride Capsules 15 mg
Flurazepam Hydrochloride Capsules 30 mg
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Excerpt from Blacklist
But What About?
Paracetamol 500 Codeine 8mg
Tablets Effervescent
Caffeine 30mg Paracetamol 500 Codeine
8mg Tablets
Paracetamol 500 Codeine 8mg
Tablets Effervescent
Paracetamol and Codeine is Co-Codamol
Co-Codamol is a recognised drug name
(BAN)(RiNN)
Caffeine 30mg Paracetamol 500 Codeine 8mg
Tablets (Veganin)
Blacklisted Item therefore Disallowed
Anthisan Cream
1 op
Anthisan Bite
and Sting Cream
1 OP
D O Getwell
What about Anthisan Bite and Sting Cream ?
(BAN)
(RiNN)
Mepyramine
Cream 1 op
Monograph in BP
Allowed
D O Getwell
Appliances
Only
the Appliances listed on the Drug
Tariff are allowed
Only
the sizes listed on the Drug Tariff are
allowed
Check
the description to make sure it is an
exact match to the item on the prescription
An
original pack of a dressing, bandage or
dressing pack is 1
Broken
Bulk is not allowed for
Appliances
If
you dispense a complete pack or box
then this change must be authorised by the
GP before submission to BSO, they will
not accept a PC endorsement
Stock Orders Only
 Some
items are allowed on Stock Forms only
 These
are noted with an * in the Drug Tariff
They include
Suture Materials
Skin Closure Strips
Tubegauze
 These items will not be paid for on a patients
script, however they are allowed on a Nurse
Prescribers form
Mepitel Soft Silicone
Wound Management
Dressing
20cmx30cm
10
Mepitel Soft Silicone
Wound Management
Dressing
20cmx32cm
1op
Disallowed
Disallowed
Size isismade
madebut
butnot
not on
Size
on
Drug
Tariff
Drug
Tariff
Pack is 5
Pack
OP isis 15
OP
1 intended and
If 5iswas
Ifdispensed
5 was intended
and
GP must
dispensed
AuthoriseGP must
Authorise
ELASTIC HOSIERY
 Allowed
on prescription
Class 1
Class 2
Class 3
Any type of Elastic Hosiery conforming
to the Drug Tariff specification may be
dispensed. Payment will be the current
Drug Tariff price
ELASTIC HOSIERY
In
the absence of a length - Thigh Length
In
the Absence of a Class
- Class 2
In the absence of a quantity
Stockings
Stocking or Hosiery
2
1
Elastic Stockings Class 2
1op
1 Pair
Thigh
1 PairLength
Thigh Length
Elastic Hosiery 1op
Thigh Length
Class
Thigh2Length
I Class
Stocking
2
I Stocking
Made
to Measure
◦ Made to measure hosiery must be
requested by the GP
Measured and Fitted (extra 15% paid)
◦ Measured and Fitted hosiery should
be coded accordingly (once only for
any specific patient)
◦ Stockings that are made to measure
can have a measured and fitted fee
4884/2
4814/2(M&F)
ELASTIC HOSIERY
DISALLOWED
Tights
Flight
Anti
Socks
Embolism Stockings (TED)
LYMPHOEDEMA
GARMENTS
Listed
as a separate section in the Tariff and
includes several brands and varieties of
garments
As
with other Dressings and Appliances
only the types and sizes on the Drug Tariff
are allowed
DRESSINGS AND APPLIANCES
DELETED FROM THE DRUG TARIFF
How
will I know if a Dressing or Appliance
is deleted from the Tariff ?
Monthly updates from BSO
These are sent to Pharmacies prior to the new
months Drug Tariff
What
happens if a Dressing or Appliance is
deleted from the Tariff ?
It is no longer allowed on prescription and no
further scripts will be paid
EXAMPLE OF LOSS WHEN
DISALLOWED
Urgotul
SSD 15cm x 20cm 7.36
If deleted from DT
A form for 10 dressings would be a loss
of £73.60
LISTED AS APPLIANCES
ON THE DRUG TARIFF
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Irrigation Fluids
Catheter Maintenance Solutions
Skin Adhesive (Sterile)
Sodium Bicarbonate Ear Drops (Thornton & Ross )
Olive Oil Ear Drops
Sodium Chloride Nasal Drops
Nasal Powder and Sprays (not all)
Emollients and Barrier Preparations
Eye Drops (not all)
Head Lice Solutions (not all)
Inhalation Solutions
THESE ITEMS ARE
MARKED