RxOne PBS Online

This is the RxOne User Manual for PBS Online and Claims. You should also have received a PBS Online Welcome Pack from Medicare Australia. Please read the contents of your Welcome Pack before you begin transmitting via PBS Online.

Installing PBS Online

On the Master computer, insert the RxOne PBS Online update disk. From the RxOne Start Menu go to Tools, Update, RxOne Update.
Follow on screen instructions to complete the update.
- A DOS black window will appear. Wait for it to close. This may take a few minutes.
- Next a 'Java Runtime Environment' menu will appear. Click on 'Next' to install.
Following the installation restart your Master machine. Start up your slave computers. This will update the files on the slave machines.
On the computer with Internet access (this could be the master or a slave machine), insert the disk containing the PBS Online Location/Security certificates sent to you by the Medicare Australia.
Go to Tools, Options.
Select the ‘Other Settings’ Tab.
Click on ‘Enable PBS Online’.
Enter the PBS Online Code/Activation code provided by HealthSoft Ltd.
Enter the password sent to you by the Medicare Australia for the Location/Security Certificates.
Enter the letter of the drive that contains the PBS Online Security Certificates and select OK.
Enter the location ID provided to you by the Medicare Australia.
Enter '1' as the number of scripts sent each time.
Tick 'Start PBS Online On Startup'. This will enable PBS Online to be started automatically when this machine is started up.
Click OK to save the changes.

Claiming online as you dispense

Start up your RxOne Master machine first as usual, and if the internet is on a different machine, then start RxOne on your Internet machine.
PBS Online will then automatically start on the internet machine.
If PBS Online hasn't started: go to Claims – Start PBS Online Claims.
The 'PBS Online’ screen will come up, click on the minimize button on the top, right hand corner to minimize this. You can view this box at anytime by clicking on the icon on the task bar. When PBS online is running, there will always be an icon on the task bar.
Begin dispensing.
As each script is finished dispensing it is sent automatically to Medicare Australia for claiming.
The main Dispense screen will refresh automatically showing the claim result/response status beside each script:
Paid: This script has been accepted for payment.
Paid (E): There has been an error with the script but the script has been accepted for payment.
Error: The script has been rejected (coloured red) and payment will not occur until the error is corrected and the script is resubmitted to Medicare Australia
Held Rx: The script is on hold.
Credit: The script has been credited.
When PBS Online is running on the internet machine, dispensing can continued as normal on other dispense slaves, the scripts dispensed from these computers will be automatically submitted for online claiming.
See below for viewing the reason codes for errors and how to reclaim after correction.
At the end of the day, maximize the PBS online box and then select close. Exit RxOne then go through your Back Up procedures as normal.
You can personalise the colours of the various PBS Online return types. To do this, from the main Dispense screen, go to ‘Options – RxOne Options – PBS Online Colour Highlight Chooser’.

Viewing errors and reason codes

You can view any errors from Dispense or from Claims.

From Dispense:

Select the script by either double clicking on script in daily log screen or searching by script number.
Click on the Claim Response Tab (6) to view the reason codes and explanations. Make the necessary corrections and select ‘Reclaim Script’.
Errors should be corrected and resubmitted to Medicare Australia as soon as possible

From Claims:

Go to Claims, select Claim Response, and select the Claim period. From here you can view all the scripts and the PBS response.

Reclaiming edited/corrected scripts

Edit/correct the script.
Select the Claim Tab (5).
Click on ‘Reclaim Script’ to resubmit to the Medicare Australia.

Crediting/ Canceling a script

Select the script to Credit/Cancel. Select the Claim Tab (5), and select 'Reverse Payment On Rx Already Claimed'. This option will only be available on scripts that have been successfully claimed.

Delayed Supply (Pend Script)

At the end of a claim period, if a request for payment transaction has been submitted to PBS Online , but the item has not been supplied to the customer during this claim period, go back to the script and 'pend' the transaction by

Selecting the Status Tab (1).
- Tick the ‘Pend Rx Claim’ box.
- Finish the script.
- The script will be credited and held until ‘Pend Rx Claim’ is unticked.

Closing a Claim Period

PBS Online pharmacies continue to close their claim period as frequently as they did when using CTS e.g. once per month. At the end of the claim period, the relevant paperwork must still be sent to Medicare Australia with a claim for payment form however a diskette is no longer required. The claim package and claim for payment form should have the PBS Online orange stickers put on them for Medicare Australia to easily identify the claim as being a PBS Online claim. Paperwork for scripts that have been rejected online should not be sent to Medicare Australia as they are not claimable until they have been corrected and resubmitted.

You have contacted the Medicare Australia to refer the script for an operator to looks at as you do not believe the script should be rejected;
You have entered a processing code of ‘01’ for a concession script where you have sighted a valid concession card and believe the customer is entitled (refer to section 10)
You were not able to communicate online with Medicare Australia at the time the script was dispensed however; when communications came back up, the script was rejected. Medicare Australia will treat these as they would a CTS claim as there was no online assessment available to complete the relevant checks prior to supply to the customer

Before closing a claim period, correct any outstanding errors:

Go to Claims, PBS Online Claims.
Click on ‘Claim Response’ report.
Select the Period you are going to close.
Select the ‘Unpaid Errored Items’ tab.
You can “double click” on any script on this report which takes you in to script editing mode.
Check these scripts and correct any errors, then tick ‘Re-claim Script’ on the Claim tab.

Close PBS Online.

Go to the machine running PBS Online.
Select claims, Close PBS Online.
Wait for it to close.

Close the claim period.

Go to Claims, PBS Online Claims.
Run the ‘Exception Report’ to get a list of scripts not currently in the claim.
Run the ‘Pended Scripts Report’ to get a list of all scripts marked as ‘Pend Rx Claim’. You can double click from this report to go in to script editing mode for the selected script, and untick ‘Pend Rx Claim’ if you wish to include the script in the current claim period.
Click ‘Close Claim Period’.
Select the Period you want to close.

PBS Statement and Reconciliation

RxOne will automatically check for a new PBS statement and reconciliation daily. These will download to the computer.
To view a PBS statement, go to Claims, PBS Online, View PBS Statement and select the claim period. This statement shows the payment, variances and errors against each script.
If you need to obtain a duplicate statement, go to Claims, PBS Online, Get PBS Statement and select the claim period to download the statement.
To view the Reconciliation, go to Claims, PBS Online, Reconciliation, select the claim period. This report shows the PBS payment IDs and amount paid for each category. This can be used for your bank statement reconciliation.

Troubleshooting

PBS Online not working

This will be indicated by a Red Message on the Dispense main screen

If this message appears, go to the PBS Online computer and maximise the PBS Online box. Check what the error message is.

For Error 3001 – Internet Connection down.

On the internet machine, check to see that all the cables are plugged into the computer
If the cables are ok, then reboot the computer.

Any other 3000 – 3999 error.

Phone Medicare Australia’s eBusiness Service Centre to see if their systems are working.

RxOne will try to connect up with PBS Online hourly and automatically resend the claim requests.

Concession Customers

a) In the situation where the Medicare Australia advises a customer is not concessionally entitled but you have sighted a valid concession card for the customer, discretion is available in the system to flag these for Medicare Australia’s attention. There may also be the situation where a customer has become eligible for Centrelink benefits that day but Medicare Australia will not recognize the number as valid as Medicare Australia will not be advised of the customer details until that night. If the customer provides evidence of eligibility then go to the script concerned, select the Claim tab (5) and then in the processing code box, select '01' (The 'concession error'' processing code).

Support

Contact the relevant Medicare Australia Support team, as per details in the PBS Online contact card, if you have any queries regarding your PBS Online transmission, payments, rejected prescription enquiries etc.

RxOneAU

PBS Claiming