PBS Claims

View, organise and close claims using the PBS Claiming functionality.

Review and organise the scripts

1. From the Activities menu, select Pharmpay Claim, then select the relevant options or (<ALT + C>).
   • Pre Preparation report. Use regularly to check against the hard copy scripts. Use to view claim data within a specific date range or by claim reference number. This report shows every script that is currently being claimed for.
   • Script/Claim number display. Use to locate any lost scripts. This allows you to enter a script number or serial number and locate the required item and patient details.
   • Holding/Deleted scripts report. Use to check the number of holding scripts unaccounted for. If you want to check for scripts still on hold in a previous claim, change the claim period code to that of the previous claim.

     The report defaults to reporting both “holding” and “deleted” scripts. Holding scripts display with H in front of them and Deleted scripts display with X in front of them. If you only want Holding scripts displayed, change Include Deleted Scripts from Y to N before generating the report.

   • Excluded Claim number report. Use to check for serial numbers that will not appear in the claim due to scripts being cancelled, put on hold or reclaimed.
   • Cancel Claim numbers. Use to cancel a serial number without cancelling the script.
   • Claim Analysis report. Only print this report if required. This is not needed for the claim but can be kept for future reference.

Finalise the claim

It is recommended that you run a Rejection report and a Validation report to ensure your claim is ready to be closed.

Run the reports

1. From the Activities menu, select Pharmpay Claim, then PBS Online Parameters reports or (<ALT + C>), B.
2. Set the Report Type field to R to run the Rejected/Non-Transmitted report.

   This report is used to identify prescriptions that have been rejected or have not been successfully transmitted to Medicare Australia in a claim period.

   

   

   When the claim no longer contains scripts with a rejected status, the following blue message is displayed.

   

   It is advisable that rejected scripts are modified and corrected to ensure transmission and payments are processed. A claim with non-transmitted scripts cannot be closed .

3. Return to the PBS Online Reports dialog, and set the Report Type field to V to run the Claim Validation report.

   

4. Select the relevant Claim Validation Options or All Validation Options, then click OK to generate the report.

   

   The Claim Validation Report checks for problem prescriptions in your current claim. This report also identifies non-transmitted scripts in the claim.

   

   A claim cannot be closed if it contains non-transmitted scripts.

Close the claim

1. When you are ready to close the claim, select Generate/Finalise Claim File from the Activities menu or (<ALT + C>), G.
2. At the prompt, click Yes to confirm you want to generate and finalise the claim.

   

   The Paperless Claim for Payment Certification is displayed.

   

3. Acknowledge the certification (with a tick R) and enter the pharmacist’s initials.

   As usual, it is recommended that your scripts are sorted and stored correctly.

The Paperless Claim for Payment Certification is displayed only when all PBNS scripts are successfully transmitted to PBS Online.

If you receive a Non-Transmitted Scripts Warning whilst attempting to close a claim:

1. Ensure that you have checked that Fred Connect is running.
2. Check you have a working internet connection.
3. Click OK to try to transmit the non-transmitted script(s) now
4. Re-check the Validation report for non-transmitted PBS online scripts (as explained above).

   

   Fred Dispense will display the non-transmitted Warning whenever attempting to close a claim that contains non-transmitted scripts.

   If there are three consecutive close claim attempts that report the same number of non-transmitted scripts, the following prompt will be displayed.

   

   If you have performed all the checks described above and re-attempted to close without success, contact Fred Help for assistance.

   Generating Claim for previously closed claim periods is not recommended as best practice with the new claiming processes.

   It will result in a rejection message from PBS online advising that the claim has already been closed.