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Pooled code practices warned to check for significant reimbursement shortfalls

Contact your commissioner about advance payments

November 18th 2022

Tagged: Dispensary guidance news

By DDA CEO Matthew Isom

Practices in England and Wales with a pooled list are being advised to check for significant shortfalls in reimbursement since the transition from Open Exeter to PCSE.

Pooled list IDs begin with 7 in the format, eg, Dr A T XXXXXXX ID. Practices should have copies on their files of their submitted FP34Ds, on which the pooled code, if used, will be listed.

To understand if or how you have been affected, it may help to compare year-on-year payments for high volume periods, ie October-December 2021 versus 2020, where the discrepancy may be more obvious.

Further support is available from NHS BSA on email: [email protected].

Affected practices may also be entitled to advance payments to support cash flow.  Please contact your local commissioner.

Transitionary arrangements until March 31 2023
Drug reimbursement claims submitted from October 2022 using a pooled list code will be amended by the NHS BSA and allocated to the Senior GP Partner prescriber number. The NHS BSA will contact the affected practices and provide support to ensure future claims are submitted using a GP prescriber number.

From 1 April 2023, please ensure that all claims are submitted using a GP prescriber number. It would be good practice to start using GP Prescriber numbers now – rather than a pooled code – when submitting your prescriptions for reimbursement.

Investigations by the DDA reveal that the problem may affect reimbursement claims from April 2021.

The DDA has also been told that the problem is due to the PCSE system not having the technical capability to process claims with Pooled List IDs nor to make adjustments for payments due but rejected due to the pooled code.

An explanatory letter is available to download.

Please check your FP34D (or equivalent).