Claiming for High Tech Not Dispensed Fee (Patient Care Fee)

As part of providing the service of dispensing High Tech drugs to the patient, pharmacies are eligible to claim a High Tech Care fee, also known as a Patient Care Fee for handling these products for patients.

Pharmacies can claim a Patient Care Fee in the following circumstances:

• The same month a High Tech Drug is dispensed.
  • This is claimed normally by dispensing the item and sending it in the Claim.
  • This will give you the full Patient Care Fee (approx €63.52)
• In the 1st month after a High Tech drug has last been dispensed and is not being dispensed this month.
  • This is claimed by dispensing the drug and marking it as Not Dispensed and giving it the relevant Not Dispensed Reason.
  • This will give you the full Patient Care Fee (approx €63.52)
• In the 2nd month after a High Tech drug has last been dispensed and is not being dispensed this month.
  • This is claimed by dispensing the drug and marking it as Not Dispensed and giving it the relevant Not Dispensed Reason.
  • This will give you HALF of the Patient Care Fee (approx €31.76)
• In the 3rd month after a High Tech drug has last been dispensed and is not being dispensed this month.
  • This is claimed by dispensing the drug and marking it as Not Dispensed and giving it the relevant Not Dispensed Reason.
  • This will give you HALF of the Patient Care Fee (approx €31.76)

To Claim a Continuing Care Fee for Hi-Tec Patients:

In the claims section there is an option to create all at once, the claimable HT scripts ( patient care fee scripts) for the month that you are claiming for.

• Go to Modules--> Claims

• Select HT Care Fee tab

• Press Select All at the bottom right hand side of the page

• Once the selected tick box beside all the scripts are ticked then press 'Request'

• A pop up box will now appear. Put in your pin number and the reason for the not dispensed scripts

• Once you press okay a message will appear to say how many scripts are now in the Not validated tab for the HT Scheme

• Go back to the Status Tab and in the HT Scheme Not Validated section those scripts are now ready to be verified/validated for claiming.

You can also manually create HT Patient care fee not dispensed scripts on a Patients PMR

• Select the patient's record as normal
• Select the last Hi-Tec dispense for the patient
• Repeat the Dispense
• Click 'Not Dispensed', or Hit Alt & T
• Enter a Not Dispensed reason
• Edit the GMS No., replace with "88999"
• If there is more than one item dispensed, replace the GMS No. for each item
• Complete the dispense as normal.

• In the Claims module:

• Validate and Verify the dispense as normal