There is a lot of information about Schemes that are either hardcoded in the system or should not be changed as it relates to reimbursement of a public Scheme e.g. General Medical Services.

The best way to think about Schemes is in terms of PRIVATE vs PUBLIC.

A PRIVATE scheme is like Drug Refund where the patient pays full price for the products along with any fees and markup you decide to charge them in order to maintain a profitable business. Since dispenses under these schemes will not be claimed for reimbursement from the PCRS, you are free to decide on the charges presented to patients.

A PUBLIC scheme is like General Medical Services. Here patients only pay a set amount per month for items dispensed under this scheme and there are specific rules around the reimbursement of these dispenses by the PCRS. Other public schemes have different rules around pricing and reimbursement. The implementation of the rules in the dispensary system is managed by TouchStore. There are, however, some other configuration settings you may wish to change.

The key configuration settings for Schemes that you may be interested in are:

Pricing
Printing
Other

Claiming Method

Public schemes are further divided into the way in which dispenses under them are claimed for reimbursement.

There are two methods:

- Electronic Claiming

Electronic Claiming of Schemes is done via the PCRS web service and requires a Claiming Certificate issued by HSE PCRS. The TouchStore dispensary system uses this certificate to securely transmit your claim file to the PCRS.

The following schemes are eligible for Electronic Claiming as of APRIL 2020:

- Manual Claiming

Manual Claiming of Schemes is done by presenting all of the relevant paperwork to the PCRS.

The following schemes are eligible for Manual Claiming as of APRIL 2020: