Lodgement of Claims by Community Pharmacists
24 Lodgement of Claims by Community Pharmacists
Claims by Community Pharmacists under this Part shall be made in accordance with section 99AAA of the National Health Act 1953 as though references in that section, and in the rules made under that section which relate to the supply of and payment for Pharmaceutical benefits under that Act and its Regulations, were references to the supply of, and payment for, Pharmaceutical benefits, except that:
prescriptions for the supply of Pharmaceutical benefits under this Part shall be marked in the S section or S sections (as defined in those rules) with one or more serial numbers allotted in respect of each Pharmaceutical benefit commencing at “R1” in each claim and continuing consecutively in respect of that claim;
these prescriptions shall be collected into one bundle, separate to the four bundles provided for in those rules, with the prescriptions sorted into the order of the serial numbers allocated under subparagraph (a), with the least serial number at the top of the bundle; and
the information to be provided to the Secretary to the Department that administers the National Health Act 1953, in respect of each supply of a Pharmaceutical benefit shall include a Form Category (within the meaning of the schedule to those rules) with a value of “8” where the Pharmaceutical benefit was supplied on an original authority prescription or “9” where the Pharmaceutical benefit was supplied on a repeat authority prescription, and a Payment Category (within the meaning of that schedule) with a value of “4”.
Note (1): this provision incorporates into the Scheme, among other relevant “National Health Act 1953 requirements” (particularly the requirements in the claims rules made under subsections 98AC(4) and 99AAA(8) of the National Health Act 1953), the requirement for a claimant to include a “supply certification form” with a claim (manual and electronic).
Note (2): if a claim is made electronically, the supply certification form is to be given electronically (claims rules).
Note (3): for electronic claims, prescriptions need not be provided (claims rules).
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