5. Chronic Medication Service (CMS)
Differences between CMS and AMS claiming and endorsing
It should be recognised that there are some significant differences between CMS and AMS which are noted here.
CMS claims can only be made electronically. Whilst the master prescription form should be submitted to PSD at the end of the dispensing period, the form is not used to support payments. The form will be scanned and its image retained at PSD but it has no role in the payment process. As a result no endorsements should be added to the master paper CMS prescription as they will not be seen by PSD operators. For CMS claims an image of the electronic claim data (including endorsements) is presented to the PSD operator to process.
This endorsing guide should be used to support electronic endorsing of CMS claims, but with some caveats.
Limited Life and instalment dispensing should not be used in conjunction with CMS claims.
A new endorsement (Other – OTH) was originally introduced to support CMS (see 2.2.10). This can be used by the CP to convey information to PSD that would normally be written onto the paper GP10 form. This information will then be seen by a PSD operator when the electronic claim is processed.
N.B.The use of this endorsement has now been implemented to support AMS prescription claims.
If there is no dm+d code available for a dispensed CMS item, some of the fundamental requirements will be unavailable electronically to PSD; therefore you must supply all relevant endorsements to ensure accurate reimbursement of the claim when the dm+d code is missing. This would include Packsize and Brand or Manufacturer endorsements when there is a choice of pack available to the Pharmacist. Quantity endorsements are not required for CMS claims as the quantity dispensed by the CP will always be supplied in the electronic claim.
Any documentation which supports a CMS claim e.g. invoice should be submitted to PSD at the end of the dispensing period along with the CMS master prescription.