Claiming reimbursement for electronic prescriptions

Once an electronic prescription has been dispensed to a patient, a dispense notification needs to be sent to the Electronic Prescription Service (EPS). The dispenser can then send an electronic claim for reimbursement to NHS Prescription Services.

Once a prescription has been dispensed to the patient via EPS, the dispenser must send a 'dispense notification'. The dispense notification may also be referred to as a 'dispensed', 'collected' or 'complete' notification, depending on which Pharmacy Medicine Record (PMR) system you use.

The dispense notification must be sent before claiming reimbursement (some PMR systems may allow you to send a dispense notification and claim reimbursement at the same time).

Exemptions need to be recorded electronically before a dispense notification and reimbursement claim message are sent.

The exemption declaration can be captured on a dispensing token or a prescribing token. Whichever type of token you use, it must be sent to the NHS Prescription Services at the end of the month.

Many PMR systems default to chargeable status, so always check the details are correct before sending the claim.

NHS Prescription Services bases payment solely on the information given within the electronic reimbursement claim (never handwrite an endorsement onto a token). It is important that this information is correct before the claim is submitted.

Any endorsement codes and supporting information can be submitted with an EPS prescription. For more information, see NHS Prescription Services' endorsement guidance.

To claim reimbursement of electronic prescriptions, the dispenser must send an Electronic Reimbursement Endorsement Message (EREM). The EREM may also be referred to as 'prescription claim message', 'dispense claim message' or 'electronic reimbursement endorsement claim', depending on which PMR system you use.

Dispensers will need to decide when to send their electronic reimbursement claims. For example, these could be sent:

• in real time (some PMR systems allow an electronic reimbursement claim to be sent at the same time as a dispense notification)
• at the end of each day
• in batches
• weekly

When a prescription is dispensed, the dispense notification must be sent within the same month, and the electronic reimbursement claim must be sent before midnight on the 5th day of the following month. If this deadline is missed, reimbursement will be delayed.

All electronic reimbursement claims must be sent no later than 180 days after the dispense notification.

If you think you've submitted a claim for reimbursement containing an error, you may be able to use the 'Claim Amend' function of your PMR system to recall a claim and correct the error. If this function is not available on your PMR system, you will need to contact NHS Prescription Services in the same way that you would for a paper FP10 prescription.

NHS Prescription Services staff will contact you by telephone to resolve any queries that arise whilst processing.

If the electronic reimbursement claim is rejected for technical reasons, you will receive a 'reimbursement rejection' message on your system. This means that there is insufficient information to process your claim, and you should call your system supplier to investigate the problem.

Tokens signed by the patient/representative to capture payment/exemption declarations must be sent to NHS Prescription Services in the same month that the electronic reimbursement claim is submitted.

The way your prescription and tokens are bundled and sent to NHS Prescription Services is very important.

Tokens do not need to be sorted in the same way as FP10s. This is because they are retained for information purposes only, and are not scanned.

Dispensers need to separate FP10s and tokens, and secure these two separate groups with strong elastic bands (or string) before they are sent to NHS Prescription Services.

Tokens printed for dispensing purposes that have not been signed by the patient do not need to be sent to NHS Prescription Services. These should be confidentially destroyed.