The transaction details screen is a live feed of information between the pharmacy and Medicare.  Detailed on the page is a status update of every PBS script processed by the pharmacy and claiming information from Medicare.  This includes reason codes for any rejections, warnings, or extra information from Medicare. An estimate of the rebate to be paid is also indicated; this amount is confirmed on the statement details page after the payment is made to the pharmacy.

 It is essential to run periodically (e.g. every day) to capture any PBS Online rejection/warning messages that may result in non payment from Medicare. The report can be filtered to select out various parameters (e.g. by script type, by message type) or it can include all items. Problem scripts can be edited directly via this screen. The report can also be printed or exported into Excel if required.

To access the report:


Dispense

7. Specialized Facilities
2. PBS Claim Processing menu
3. PBS Claim via PBS Online menu
1. PBS Online – Transaction Details

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To view the transaction details, the following information is required:

 Field 1: Enter the Pharmacy’s PBS approval number e.g. HS027J

  • The ? prompt will bring up a lookup for all local approval numbers.
  • You can enter a script number to view details for a particular item, or an approval number for a particular site to view all scripts.

 Field 2: Filter Option – select Script type (G,C,E,R,B) or press <A> to include all script types:

  • G for General
  • E for Entitled
  • C for Concession
  • R for Repatriation
  • B for Doctors Bag

 Field 3: View Option – This field dictates what information is displayed.  Select F for Financial (includes payment discrepancies) or C for Claim list (summary version).

  • The main difference is the prescription item is included in the detail on the Claim List. 
  • However, the Financial view contains a more complete picture of the prescription claim details.

Field 4: Status: Filter Option – select which items to display (e.g. rejections only) or press <*> to include all scripts regardless of status.

  • “O” for OK to send in script bundle (this groups together A and S)
  • “I” for Items with a problem (this groups together W, R, B and H)
  • “N” for Non-CPAP items with a problem
  • “W” for  Waiting to send
  • “A” for Accepted
  • “R” for Rejected
  • “S” for Send Paper – Pending
  • “H” for Rejected, paper required
  • “C” for Cancelled
  • “B” for Unable to Cancel
  • “X” for On Hold

Field 5: Enter PBS claim period (e.g. 1007)

or

Field 6 & 7: Enter date range

The report automatically appears on the screen.

If you select “F” for Financial View in field 3, an example report is shown below.

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If you select “C” for Claim List View in field 3, an example report is shown below.

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Several functions can then be performed from this screen – at the Option Line:


  • To view details of a script: press D and the line number e.g. D26
  • To edit a script: press E and the line number e.g. E26
  • To place a script on hold: press H and the line number e.g. H26
  • Print/Display a report: press P
  • Export a report to Excel: press X

“D#” – Details

Enter D and the line number required and a detailed prescription window will open.  This window is a display only and no data can be entered here.  If the item has been issued with a reason code from Medicare, further details are outlined.

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“E#” – Edit/Remove

Enter E and the line number required and a warning message will appear.  If Y is selected, the dispensing screen will open and details of the prescription may be edited.

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***To Reclaim a script you must use the prompt W in the Dispense Screen. This will generate a new serial number***

“H#” – Hold

Enter H and the line number required and a warning message will appear.  If Y is selected, the prescription will be placed on Hold and not submitted to Medicare with the current claim.  The status code will become an X.
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 “P” – Print/Display

Enter P and the following message will appear.  

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If Y is selected, the following Print Option message will appear.  

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If P is selected, a Printer/FormQ Assignment box similar to the following will open with site specific printers.  To select the appropriate printer, arrow through the list and select Enter to print.

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If D is selected, the current view will appear in a Display screen like the following.  To scroll through each page, use the Return or Enter key; select Esc to escape.

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“X” – Export

Enter X and a message will appear with the export drive destination.  Check the details are correct and press Enter for the data to be exported to Excel.

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Below is an example of the exported data in Excel. Make sure a blank Excel worksheet is open before you export the report from Merlin.

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