Outstanding Errored Scripts Report:
It is good practice to run an Outstanding Errored Scripts Report on a regular basis to mop up prescriptions that have had errors that may have been inadvertently missed. You should run your LBL (Line By Line) report every time you process a claim.
This report looks through each script that has been electronically claimed in the previous 3-4 months, and checks all the claim transaction responses. If the amount claimed matches a payment on any of the claim responses then it’s considered paid and will not appear on the Outstanding Errored Scripts Report.
a) Drug A, claimed 1/7/20 and claim amount =$4.00, 1/7/20 claim response says paid $4.00 (i.e. same as amount claimed, then considered fully paid). This will not appear in the report.
b) Drug B, claimed 1/7/20 and claim amount=$4.00, 1/7/20 claim response says paid $4.00,then for whatever reason the script was sent back into the 7/7/20 claim with ‘Resubmit not yet paid’. 7/7/20 claim response comes back as ‘errored’ as script has already been paid. Even though the script has errored on the very last claim, because a full payment (compared to amount claimed) has been made, this script will not appear in the report. This is why you should always have a look at your errors report for each claim.
c) Scripts where there is still a balance owed will appear on the report because the quantity claimed is the partial quantity dispensed, but the $ amount claimed sent into the claim is for the full quantity. This means that the $ amount paid in the claim response will not match the total $ amount claimed if there is still a balance owing.
Certified Repeat Copy Prescriptions – New Look:
Utility to set Close Control Flag in Exceptions Report and Claim Response:
If you have scripts with ‘Stat list Drugs, Close Control Not Ticked’ on your Exceptions Report, you can highlight the scripts and go to ‘File’ on the top menu and select ‘Mark as Close Control’. This will tick the close control box on these scripts.
In Claim Response, if you get a ‘Close Control Not ticked’ claim error, you can highlight the script and right mouse click to bring up a list of options and then select ‘Mark as Close Control’.