As part of our Funding & Reimbursement Shorts series, Community Pharmacy England’s in-house Drug Tariff funding and regulatory experts have created a new video on out-of-pocket (OOP) expenses.

In this video, we explain how pharmacy teams can claim out-of-pocket expenses incurred when obtaining eligible drugs or appliances for dispensing against NHS prescriptions. We also cover which product categories are eligible for claims, the circumstances under which a claim can be made, and provide practical guidance on record keeping, submission and monitoring of claims for payment, so pharmacy owners can be confident their claims are appropriate and supported if reviewed as part of post-payment verification activity.

In this video, Gemma Hackett (Dispensing and Supply Officer) and Katrina Worthington (Regulations Officer) explain the following:

  • The Drug Tariff requirements for claiming out-of-pocket expenses
  • Product categories eligible for out-of-pocket expense claims
  • Examples of costs that can be treated as out-of-pocket expenses
  • Correct endorsement requirements to claim for out-of-pocket expenses on EPS and FP10 paper prescriptions
  • How to monitor out-of-pocket payments using the FP34 Schedule of Payments and Prescription Item Report (PIR)
  • The outcomes of the most recent post-payment verification (PPV) exercise on claims for out-of-pocket expenses
  • Key learnings from recent PPV activity, including common reasons why certain claims were not considered appropriate

Watch the out-of-pocket (OOP) expenses video here:

Related resources

The NHS Business Services Authority (NHSBSA) has developed guidance to help support pharmacy owners with out-of-pocket expense claims and to highlight the outcomes of the most recent post-payment verification (PPV) activity. See NHS BSA Out of Pocket Expenses – Guidance for pharmacy contractors.

Additional information can be found on our Out-of-pocket expenses page.

Funding & Reimbursement Shorts

Community Pharmacy England’s Funding & Reimbursement Shorts series aims to provide pharmacy owners and their teams with more information on common funding and reimbursement topics, enhancing understanding of specific topics and addressing common queries. In the videos, our in-house Drug Tariff and funding experts will offer practical advice on topics such as:

  • Paper prescription sorting and submission process
  • End of month submission process
  • Handling prescriptions with supplementary product information
  • Price concessions
  • Dispensing claiming SSPs
  • ‘FS’ endorsed prescriptions
  • Original pack dispensing (OPD)

The videos are supplemented by factsheets and briefings produced by the Dispensing and Supply team, including the overarching ‘Top tips to maximise dispensing income’ factsheet, which links to a wealth of resources and serves as a handy written checklist for the wider pharmacy team.

Later videos will cover topics such as referred back and disallowed items and EPS claiming. We would also welcome your suggestions for other future topics – please email  ds.team@cpe.org.uk  with any suggestions.

The post Funding & Reimbursement Shorts: Out-of-pocket (OOP) expenses appeared first on Community Pharmacy England.