Throughout the month, and at any point before you send off your End of Month claims, you can review and prepare the scripts you wish to claim for. There are two major steps in the Preparation stage:
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Validation: Tell the system which scripts you want to claim for
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Verification: Run some key checks to ensure there are no major errors with the scripts that would prevent payment
Validation
How to Validate Scripts for Claiming
Before you can send your claim, you first need to tell the system which of the scripts you have dispensed throughout the month you wish to transmit to HSE PCRS for reimbursement.
To begin validating scripts:
- Select Modules--> Claims
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The main summary screen will be displayed
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Select the Claim Period that you wish to claim for
- A total number of all scripts that have been dispensed under each scheme will be displayed under Not Validated
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Press the Not Validated tab to begin validating the scripts
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Select the scheme you would like to validate first from the Scheme dropdown or select All to validate all scripts
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On this screen you will see a listing of all scripts for the currently selected scheme
- Check each script to ensure all items have the correct patient reference, date, scheme, doctor and product gms number
- You can use the Claim Defender button also. This will look at all scripts displayed on the screen and will flag (The 'query' box will be ticked) any problematic scripts along with the error.
- NOTE: You will need to uncheck the query box manually before validating. Any queried scripts will remain in the not validated tab if not unchecked.
- Tick the Validated box for each script that you have reviewed and want to Validate as a script you wish to claim.
- If you need to follow up on a script/item or you're unsure if you can claim for it and want to return to it a later point, tick the Query box, this will hold the script in this section for later review
Quick Tip: Use the spacebar to mark scripts as validated and use the arrow keys to move between scripts for quick navigation
- 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
