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Apr
3

Reducing Disallowed Items

BY GREG BULL  |  POSTED IN GENERAL NEWS

Once a prescription has been dispensed it effectively becomes an order form for payment. 

If the prescription is somehow incorrect then your surgery may not be paid correctly, or even at all if the item dispensed is disallowed. 

The other main problem with prescriptions is when an exempt prescription [the patient doesn’t pay] is switched to a paid prescription. 

For each switched item, your surgery will lose the prescription fee.

One golden rule is that you should always ensure that the reverse of the prescription form is signed (excluding Personally Administered items) and CHECK that it has been filled in correctly to prevent NHS BSA from switching exempt prescriptions to paid.

Returned prescriptions delay payment to the practice and can eat up your time trying to work out what exactly is wrong with them. 

Ideally you should endeavour to reduce your prescription errors in this area to a minimum.

The most commonly disallowed items include:

Appliances (dressing and bandages are all    appliances) which are NOT listed in Part IX of the Drug Tariff.

Items which are ‘Blacklisted’ and should not be prescribed and dispensed on an NHS prescription.

A chemical reagent not listed in the Drug Tariff.

The most common causes of switched prescriptions (From exempt to paid category) include: 

An exempt prescription which has not been signed

A prescription where the signature format is unacceptable – for example the signature does not register on NHS BSA scanners as it is outside of the box.

An item not properly classified as contraceptive which can be used for other clinical reasons than contraception.

The most common causes of returned prescriptions include: 

A generic prescription for an item which is not listed in Part VIIIA.

The prescription is incomplete, for example the dosage or strength is missing on the form /presentation of the medicine (i.e. solution/tablet/capsules)

More than one manufacturer could have produced the brand dispensed.

Tips for avoiding prescriptions being disallowed or returned:

Check Drug Tariff Part XVIIIA - if you think the item may be “blacklisted” 

Check Drug Tariff Part XVIIIB - if you think the item may be on the Selected List Scheme 

Check Drug Tariff Part IXA - If the item is an appliance such as a bandage, dressing, head lice treatment etc.

Avoiding those referred back prescriptions is an important part of the dispensary team’s function.