It's important that you sort your prescriptions into chargeable and exempt groups to make sure you get the right reimbursement.
Prescription charges and your reimbursement
When dispensing contractors send their prescription forms to us for reimbursement and remuneration, they should sort the forms into 3 ‘charge status’ groups. This will tell us whether the patient paid a charge for their items or not.
The current prescription charge that a patient should pay if they are not exempt for their item is detailed in Drug Tariff Part XVI, note 1.
The 3 groups are:
- exempt – the patient did not have to pay for their items
- chargeable – the patient had to pay for their items
- chargeable – the patient had to pay for their items at the old rate (rate before April price change)
The payment that dispensing contractors get is affected by the number of prescription items in each group.
When we identify that an item has been submitted in the wrong group, we'll change its charge status and will either increase or reduce the dispensing contractor’s payment accordingly.
Main reasons for changing the charge status
The main reasons we may change an item’s charge status include:
Changing the exempt group to paid
This is likely because:
- prescription not signed by the patient or representative (and where the patient cannot be identified as age exempt from computer-generated details on the front of the prescription).
- there's evidence that the patient or representative has paid the prescription fee
- an item is not properly classified as a contraceptive, if submitted in the exempt from charges group
Changing the paid group to exempt
This is likely because:
- the form was completed with all necessary exemption details
Age exempt patients
In 2005, there were amendments to the NHS charges regulations. There's no longer a requirement for certain age exempt patients to complete the exemption declaration on the back of the prescription form.
This only applies to patients whose date of birth or age is computer generated on either a paper prescription form or appears as part of an electronic prescription message (EPS).
The relaxation also applies to repeat prescriptions where the patient’s date of birth or age is computer generated.
Patients claiming exemption on age grounds, but whose date of birth or age is handwritten still need to sign the declaration box (part 3).
The change only applies to prescriptions dispensed in England.