Understanding an ETP Claims Report

The ETP Claims Report gives you an indication of the number of EPS Release 2 prescriptions that have been claimed within a given month, with a breakdown of exempt and paying items and forms.

 

You can view the article on Understanding the EPS R2 Claim Schedule to help you understand the cut off dates for sending dispense notifications and claims.

The figures on the ETP Claims Report are split into 2 main sections, those which are for FP34C submission (Summary) and those which are not for FP34C submission.

For FP34C Submission (Summary) 

The figures in this section should be used to complete your FP34C submission form that you will send to the Prescription Pricing Authority (PPA).

Heading Description
Exempt Forms The total number of prescription forms that do not incur a prescription charge.
Exempt Items The total number of prescription items that do not incur a prescription charge; this figure will include No Charge Items.
Paid Forms The total number of prescription forms that do incur a prescription charge.
Paid Items The total number of prescription items that do incur a prescription charge; this figure will exclude No Charge Items.
Total Forms The total number of paid and exempt forms.
Total Items The total number of paid and exempt items.

Not for FP34C Submission 

This section should not be used to complete your FP34C submission form. This area is broken down into 3 further sections.

Items Breakdown 

This section provides a breakdown of the total number of items claimed for the given month.

Heading Description
Exempt Forms The total number of prescription forms that do not incur a prescription charge.
Exempt Items The total number of prescription items that do not incur a prescription charge; this figure will include No Charge Items.
Paid Forms The total number of prescription forms that do incur a prescription charge.
Paid Items The total number of prescription items that do incur a prescription charge; this figure will also include No Charge Items.
No Charge Items Only The total number of prescriptions items that do not incur a No Charge.

Total Fee Summary 

This section provides a breakdown of the total number of professional fees and charges collected.

Heading Description
Fee Total The total number of professional fees incurred for all prescription items (both paid and exempt).
No. of Charges Total The total number of prescription charges collected per item, on all prescriptions where patients were marked as Not Exempt at the point of claiming.

Items Summary for Selected Script 

This section provides a breakdown for the total number of items claimed for the selected prescription in the grid.

Heading Description
Items (Incl. No Charge) Total The total number of items on the prescription, including No Charge Items.
No Charge Items Only Total The total number of No Charge Items.
Exempt Total The total number of exempt items on the prescription; this figure may be the same as the number of No Charge Items.
Paid Total The total number of paid items on the prescription.

Key Points to Consider 

There are some key points to consider when it comes to understanding the full scope of the ETP Claims Report.

FP34C Submission figures 

The figures used for FP34C submission are a count of the number of items on the prescription, not the number of charges / fees. Below are some scenarios to explain.

Scenario 1 
  • 1 paid prescription contains 1 “Flavour Not Specified” item.
  • The GP specifies on the prescription that 5 flavours should be given.
  • Based on this, the figures in the ETP Claims report for a paying patient would be as below:
Paid Exempt No Charge Items Fees Charges
Forms 1 0
Items 1 0
Total 0 5 1
Scenario 2 
  • 1 paid prescription contains 1 “Flavour Not Specified” item.
  • The pharmacist chooses to give 5 flavours, however the GP does not specify on the prescription the number flavours that should be given.
  • Based on this, the figures in the ETP Claims report for a paying patient would be as below:
Paid Exempt No Charge Items Fees Charges
Forms 1 0
Items 1 0
Total 0 1 1
Scenario 3 
  • 1 paid prescription contains 3 items.
  • This could be for different strengths of the same medicine, e.g. Warfarin 1mg, Warfarin 3mg and Warfarin 5mg.
  • Based on this, the figures in the ETP Claims report for a paying patient would be as below:
Paid Exempt No Charge Items Fees Charges
Forms 1 0
Items 1 2
Total 2 3 1

Edited Claims 

Items that have been edited but not re-claimed will not be reflected in the ETP Claims Report. For example, a patient’s exemption has been changed from Not Exempt to H – gets Income Support (IS). In order for you to see this change reflected in the report, the prescription will need to be re-claimed as soon as possible after the edit was made.

Locally Added Drugs 

Where you have had to map to a manually added drug, there will be discrepancies in the ETP Claims Report. This is because locally added drugs do not have any charges or fees associated with them.

Serious Shortages Protocol  

Currently, any items dispensed under the Serious Shortages Protocol (SSP) where a lesser quantity was supplied will not be reflected in the ETP Claims Report.

EPS Release 1 

EPS Release 1 prescriptions cannot be claimed electronically. Therefore, they will not be included in the ETP Claims Report.

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