Claim Response Guide

Error 133 “More than 90 days supplied”

Explanation

The total quantity entered exceeds the 90 day supply limit for prescriptions

This is determined through the “Quantity” and “Dose/Freq”. If Quantity/(Dose * Freq) is greater than 90 day supply, you will see this error.

In the example below, the Dose/Freq is set to 1 tablet ONCE a day, but the quantity is 180. This would imply a period of supply of 180 days

Open

Fix

To Fix: Amend either the Quantity or the Dose/Freq to make the dispensing 90 days.
Tick “Resubmit Script Not Yet Paid”

Error 138 “Item supplied for more than 90 days over all dispensings”

Explanation

This is the same as error 133, however this error will most likely occur on a repeat dispensing when the total quantity across initial dispensing AND repeats exceeds the 90 day limit.

Fix

Amend either the Quantity or the Dose/Freq on each dispensing to make the total period of dispensing supply doesn’t exceed 90 days

Tick “Resubmit Script Not Yet Paid” on the script that has this error

Tick “Cancel Payment and Price Again” on every previous script

Error 140 “Original pack medicine with more than 90 days supplied”

Explanation

This is the same as error 133 and 138, however this error will occur on scripts with medicines dispensed in whole packs e.g. Inhalers, Turbuhalers.

Fix

The fix will be the same as for Errors 130 and 138

Error 152 The original of this repeat is not a paid item in the Ministry of Health database

Explanation

This error will occur on a repeat dispensing when the initial dispensing was NOT paid or accepted previously.

You cannot claim payment on a repeat dispensing when the initial hasn’t been paid.

Fix

To Fix: Open up the Initial Dispensing and click on the “Claim Response” tab and rectify the error that appears.

Error 160 Prescription ID and Suffix ID is already on Ministry of Health records

Explanation

This error means that this dispensing and its corresponding prescription number has been accepted and is already on Sector Services’ records.

It may mean the script has possibly been paid already. However, it is also possible for certain scripts to have been accepted by Sector Services with no payment.

Fix

Go into the script and in the Claim Response tab check to see if the script has already been paid. There are two ways to check:

a) Look for the green “Script Paid” under the Label Preview

b) Go to the Claim Response tab in the script and check the history of payments. If the Sum of all the “Amount Paid” exceeds the sum of all the “Amount Claimed”, then you have been paid.

If you deduce that you haven’t been paid (or been paid incorrectly), tick “Cancel Payment and Price Again”

Please note: If you have deleted a repeat dispensing and then re-dispensed it, you essentially have two scripts with the same script number. One will be the newly dispensed one, but the other will be the formerly dispensed one which is now deleted. This can be viewed in the “Deleted” tab in the patient profile. It is worth checking the claim history of the deleted script as it may have been paid originally. If this is the case, tick “Cancel Payment and Price Again” on the newly dispensed script

Error 162 Subsidy was not specified in the Pharmaceutical Schedule at the date of service

Explanation

This error will occur if you try to claim an item not specified in the PHARMAC schedule

Example 1: Dispensing a mid-month listing pharmaceutical for which claiming was not enabled on Sector Services’ end.

Example 2: Dispensing a specific brand medicine that was not listed in the PHARMAC Schedule at the date of dispensing (this occurs only when you edit a previous script to change drug brand to currently funded brand which was not funded at date of dispensing and tick ‘Cancel Payment and Price again’)

Fix

If the dispensed drug was a mid-month listing whereby claiming was not enabled at the time of dispensing, please tick ‘Resubmit Script Not Yet Paid’ after the 1^st of the following month.

If you have changed a previous dispensing of a discontinued brand to a currently funded drug brand (for the purpose of dispensing the repeat), and that script was credited but not reclaimed, please change the dispensing to the prior funded brand. Then tick ‘Cancel Payment and Price again”.

When dispensing the repeat of a discontinued brand, you can change the drug on the repeat to the current funded brand and payment will be processed according to PHARMAC listing at date of repeat dispensing.

Error 308 Maximum weekly dose of ******* exceeded

Explanation

This error means that the Dose/Freq entered in the script exceeded the maximum funded weekly dose.

This commonly occurs with Estradot patches for which they are only funded as ONE patch TWICE weekly.

Fix

Fix 1: Adjust the Dose/Freq to represent the maximum weekly dose using the formula (Max dose per week)/7

e.g. Max 2 patches of Estradot

2/7 = 0.286

Therefore the Dose/Freq will be 0.286:1

You can also tick “Always set this dose and frequency for this instruction” so it applies every time

Fix 2: Place “as directed” on the end of the instructions.

402 Credit item with no accepted original in database.
404 Resubmission item with no accepted original in database

Explanation

These two errors usually occur together and the most likely cause of this is ticking “Cancel Payment and Price again” on a script that was never paid to begin with.

A reprice can’t be done for a script that was never paid.

Fix

Check the initial dispensing and investigate why it was never successfully claimed

After making any necessary adjustments, go into the script and tick “Re-submit Script Not Yet Paid”

After, the script is submitted in the claim, check to see if it was paid or if there were any errors to rectify

Error 597 Quantity claimed to date is more than the Total Quantity Prescribed.

Explanation

This error means that the total quantity supplied across all dispensings exceeds the quantity claimed from your initial dispensing (this is the “Total Quantity Prescribed”).

This will commonly occur if you have changed the quantity of a repeat dispensing without doing variable repeats.

Example: If an initial dispensing is entered in RxOne as 30 with 2 repeats (30 + 30 + 30); when the dispensing is claimed, Sector Services accepts that the “Total Quantity Prescribed” is 90.

If the quantity on the second dispensing was changed to 70 during dispensing, the claim would show Error 0597 because 30 + 70 = 100 which exceeds 90.

Similarly, if the second dispensing was 30 and the third dispensing was changed to 40 during dispensing, the claim would show error 0597 because 30 + 30 + 40 = 100 which exceeds 90.

Fix

Check the initial dispensing to find out the total quantity prescribed.

Check to see if the quantity across all dispensings exceeds this quantity.

You must either:

-Adjust the Total Quantity Prescribed from the initial dispensing

And/Or

-Adjust the quantities across the dispensings to match the Total Quantity Prescribed

If you change the “Total Quantity Prescribed” in the initial dispensing, tick “Cancel Script and Price again”

When you are done adjusting quantities, make sure to tick “Re-submit Script not yet paid” on the script with the Error 0597