Please note:

• You can only CHECK and SEND Claim Exceptions from the Claims PC.

• You can 'FIX' Claim Exceptions on any PC from the claims module.

• You have the first 3 WORKING Days of the month to send your claim to the PCRS. You then have the following 5 WORKING Days to send your reclaims to the PCRS.

How to Check for Exceptions

Once your claim has been sent and processed by the PCRS you will then receive Claim Exception scripts back from them. These script will need to be 'fixed' and sent back in a certain timeframe in order to receive payment for them.

To check for Claim Exceptions from the PCRS:

• Go to Modules --> Claims

• You will then be brought into the claims section.

• Select the Claim Period from the dropdown

  • Please note: All claim exceptions will be displayed here. It does not matter what period is selected.

• Select the Claim Exceptions tab.

• Displayed here are scripts that have been rejected by the PCRS. These Claim Exceptions will generally have a message attached to them that will indicate why they have been rejected by the PCRS.
  • If there is NO error message displayed, you will need to contact the PCRS.

How to Fix & Send Claim Exceptions

N.B. you can only make edits to claim exceptions from the claim exceptions tab. if you make an an edit on a script by searching the patients file and clicking 'edit script', it will be treated as a new claim.

• If you need to change the Doctor, select the 'Edit GMS Doctor' button

• If you need to make a change to the patient's Card Number, select the 'Edit Patient Ref' button.

• If you need to make an edit on a dispense, select the 'Edit Script' button at the bottom of the exceptions screen

• After making your changes to a script, you will tick the 'FIXED' box

• When you are happy that you have completed all fixes, you will press the 'Re-claim' button at the bottom of the screen.

• A message will then display, letting you know how many reclaim scripts have been moved to the send claim tab.

• Select the 'Send claim' tab & on the bottom right hand corner of this screen select 'Send Re-claim'. (This button will be hidden outside the reclaim period)

Reclaiming for fixed Exceptions

N.B. Claim Exceptions can only be RECLAIMED for during the RECLAIM PERIOD in the month they were rejected.

E.G. It is April 2nd 2024, you have sent your MARCH 2024 claim and you are dealing with your claim exceptions. You have a Claim Exception for a script from DECEMBER 2023 and a Claim Exception for a script from MARCH 2024. You will be able to edit and fix any Claim Exceptions and you can push them into the Send Claim tab, however, ONLY the MARCH 2024 script will be reclaimed when you hit Send Reclaim. The DECEMBER 2023 script will stay in the Send Claim tab until it comes time to send your next FULL claim i.e. the APRIL 2024 claim and will be reclaimed then.

If you are in the Send Claim tab in the Claims module and there is no Send Claim button, please ensure you are on your Claiming PC. They will not be able to send their Claim on any other RX PC