How are your prescriptions processed?

How are your prescriptions processed?

The Pricing Authority CIP

To improve the efficiency of prescription pricing, The Pricing Authority, NHS Prescription Services, introduced an automated pricing system, known as the Capacity Improvement Programme (CIP) in 2007.

Since the introduction of CIP, PSNC’s auditing function (see this page for more details) has helped to identify some processing issues which had caused errors in payment for some prescription items. Error correction and system improvement work is ongoing, and both PSNC and the Pricing Authority are continuing to scrutinise the system closely.

Download our new factsheet relating to Prescription Pricing Accuracy.


 

Prescription Pricing Accuracy


Pricing overview

The NHSPS Pricing system uses high-speed scanning equipment and intelligent character recognition software to support the capture of printed information from prescription forms. This is supplemented by the information input manually by the Pricing Authority operators. Once information is captured, it is processed by the ‘rules engine’ to determine the payment due to contractors.

A summary of the key steps in the pricing process are outlined below. A diagram of this process can be downloaded here.

Click on a heading below to reveal more about each step:

Batch Preparation

Prescription bundles received by the Pricing Authority must first be prepared for the scanning process which can be hindered by the way prescriptions have been submitted. For information on how to properly sort your prescription bundle prior to submission please see our Sorting Your Prescriptions Prior to Submission page.

Once a prescription bundle is received, Pricing Authority staff must make sure all clips, staples and sticky labels have been removed as they can jam or damage the scanning equipment. The information that has been entered onto the FP34c submission document is input alongside the scanned images and this is used to calculate the pharmacy’s advance payment therefore it is crucial that this has been completed accurately. For more information/guidance on how to complete the submission document correctly, please see our Completing Your FP34c Submission Document & Dispatching Your Prescription Bundle page.

Prescription Information Data Capture

The scanning system is only used to support the capture of data from the prescription, for example the prescriber ID, prescription form type, exemption status and details of the prescribed items. If the scanning process cannot determine this information with confidence, for example if the prescription is handwritten, then the prescription will be referred to a Type 1 Exception Handler who will enter the prescription details manually.

Switching

At this stage if the system flags that a prescription may have been submitted in the incorrect charge group, it will be referred to a Type 1 Exception Handler for verification of whether the form was in fact submitted incorrectly or not. If it was submitted incorrectly then it will be switched. No forms are switched automatically by the system; they are only switched once verified by a trained member of staff. Further guidance on switching is available on our Prescription Switching page.

Exception Process

Prescriptions which cannot be processed automatically by the system will be sent to an operator who will manually capture the relevant information required to price the prescription.

Prescriptions that have been placed in the red separator are processed by a specialist team of handlers who are trained to price these types of prescriptions. The following prescriptions are required to be submitted in a red separator: expensive items (net ingredient cost over £100), specials and unlicensed products, items with broken bulk or out of pocket expense claims, items with hand written amendments, prescriptions where the prescribers’ signature encroaches over an item on the prescription and additional product information, such as sugar-free, where the prescriber has provided this within the dosage instructions.

At this stage, items which still cannot be priced due to a lack of information must be referred back to the contractor for clarification. Payment will only be delayed for the item for which the clarification is required, and not for any other items which appear on the same prescription form. For more information on returned prescriptions and how to prevent these being returned please see our Prescription Returns page.

Payment Calculation

Once the data on the prescription forms has been confirmed, the information will be processed automatically via the ‘rules engine’. This system will automatically apply the Drug Tariff rules for the month for which the prescriptions were submitted.

The total payment due for items dispensed will be calculated from the automatically captured data and the manually captured data. Any adjustments are made and the contractor’s final payment is calculated.


Related resources

Route of submission diagram

Payment Factsheet 5 – Prescription Pricing Accuracy

Prescription Switching

PSNC Prescription Pricing Audits

NHS BSA Information

Prescription Rechecks at the Pricing Authority

Prescription Submission

Monthly Payments



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