It's important that you sort your prescriptions into chargeable and exempt groups to ensure you receive accurate reimbursement.
Prescription charges and your reimbursement
When dispensing contractors send their prescription forms to NHS Prescription Services for reimbursement and remuneration, they should sort the forms into three distinct ‘charge status’ groups to 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 three groups are:
- Exempt – the patient did not have to pay for their items;
- Chargeable – the patient did have to pay for their items;
- Chargeable – the patient did have to pay for their items at the old rate (rate before April price change).
The payment that dispensing contractors subsequently receive is affected by the number of prescription items in each group.
When NHS Prescription Services identifies that an item has been submitted in the wrong group we will change its charge status and will either increase or reduce the dispensing contractor’s payment accordingly.
Main reasons for changing the charge status
NHS Prescription Services may change an item’s charge status for a variety of reasons, but the main ones are:
Changing the exempt group to paid
- 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).
- Evidence that patient or representative has paid the prescription fee.
- Item not properly classified as a contraceptive (if submitted in the exempt from charges group).
Changing the paid group to exempt
- Form properly completed with all necessary exemption details
Age exempt patients
In 2005, there were amendments to the NHS charges regulations; there is 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.