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Electronic Transmission of Claims

As contractors will be aware, as stated in the Drug Tariff to receive the recurring connectivity payment of £200pcm as of 31 March 2018 they were required to have a system compliant with Phase 2 releases 1,2 and 3 (which includes the Electronic Transmission of Claims (ETC) service).

As of 1 April 2019 the Drug Tariff will also include the following requirements:


“From June 2019, compliance with phase 2, release 3 will be assessed against the percentage of ETC claim messages submitted for qualifying prescription items. Qualifying items are defined as those prescribed on a WP10 prescription containing a 2DRx barcode. In order to retain the IM&T allowance, each contractor must submit ETC claim messages to meet the following thresholds:
Date Qualifying items in monthly account
From 1 June 2019 40%
From 1 September 2019 55%
From 1 December 2019 70%
From 1 March 2020 80%


NWSSP will shortly be commencing development work to add information to the NECAF home page in relation to targets such as ETC. In the interim period before this information goes live NWSSP will generate a monthly report for CPW containing the data for all 716 pharmacies which will contact a rolling 3 month position for ETC submissions. The first 2 months will show a percentage but the latest month will only show the ETC submission figures because, of course, the paper forms are yet to be received.  So, for example, March’s report will show: -
 
Pharmacy Dispensing Month ETC Submissions Valid 2DRx Forms Percentage ETC
A Pharmacy January 2019 n1 n3 n1%
A Pharmacy February 2019 n2 n4 n2%
A Pharmacy March 2019 n3 -- --

The first report has been received today by CPW;  contractors who would like to know what their current submission rates are, are asked to email info@cpwales.org.uk stating their pharmacy name, address and account number

 

Electronic Transmission of Claims (ETC) Transmission Threshold Targets
 
How could this affect my income?
Contractors in Wales currently receive a recurring ‘connectivity’ payment of £200pcm provided they meet the Drug Tariff requirements relating to the payment of this allowance.  The first of the new threshold targets for the transmission of ETC messages starts on the 1st June 2019.  To retain your allowance after this date ETC claim messages must be sent for 40% of prescriptions that contain a 2DRx barcode.
The Drug tariff requirements have however been updated as follows:-
 
How do I know what my ETC transmission level is?
 
The Shared Services Partnership has undertaken development work to make ETC transmission rates visible to contractors.  The latest performance data can be found at http://www.primarycareservices.wales.nhs.uk/etc-transmission-rates
 
The reports show a rolling 3 month position for ETC submissions. The first 2 months will show a percentage but the latest month will only show the ETC submission figures because, of course, the paper forms are yet to be received.  So, for example, April’s report will show:  
 
Pharmacy Dispensing Month ETC Submissions Valid 2DRx Forms Percentage ETC
A Pharmacy February 2019 n1 n3 n1%
A Pharmacy March 2019 n2 n4 n2%
A Pharmacy April 2019 n3 -- --

 

How to I access further information on ETC?
 
A guide from Shared Services which provides the background information to the roll out of the ETC service is available here. In addition there is a Frequently Asked Questions section on the Shared Services website at http://www.primarycareservices.wales.nhs.uk/sitesplus/documents/1150/FAQs%20-%20Electronic%20Transmission%20of%20Claims%20V2.1.pdf
 
Who do I contact if I have a problem?
 
If you are having problems with your ETC transmissions then it is important to recognise that the role of Shared Services is to receive the electronic ETC message from your PMR system, therefore if your query relates to how this message will be used in processing your dispensing account it should be referred to Primary Care Services at prescribing.management@wales.nhs.uk
 
If your query relates to the operation of ETC within your PMR then you should contact your systems supplier’s helpdesk as Primary Care Services will not be able to provide information on the operation of your PMS system. PMR Systems Supplier contact details are contained in the FAQs.
 
For additional support your CPW Director is always available for advice.  Contractors in Cwm Taf Morgannwg, Hywel Dda and Powys Health Boards should contact jonathan.rees@cpwales.org.uk and contractors in BCU, Aneurin Bevan, Cardiff & Vale and Swansea Bay Health Boards should contact Rhodri.thomas@cpwales.org.uk  Contractors can also contact the CPW helpdesk on info@cpwales.or.uk  
 
 
What do I do if I have a genuine technological reason why I cannot meet the submission rate thresholds?
 
There may be a genuine technological reason why you cannot reach the submission rate thresholds.  If you believe this is the case then you should:-
 
  1. Firstly, seek a resolution through your systems supplier.
  2. If you are part of a group of pharmacies raise the issue with the owner or head office.
  3. If the issue remains unresolved the owner or head office can complete an ETC Transmission Rate: Issues Form.  The form can be accessed at:-
http://www.primarycareservices.wales.nhs.uk/questionnaire/1384