Deadline for submission of outstanding referred back prescriptions
The October 2023 Drug Tariff has been updated to include a deadline for submission of any outstanding referred back prescriptions to the NHS Business Services Authority (NHSBSA) for payment.
All prescriptions that have been referred-back must be completed and returned to the NHSBSA no later than 18 months from the date they are first sent to the pharmacy via the Manage Your Service (MYS) portal. All outstanding referred back prescriptions can be found by checking the ‘Unpaid items’ tab on the MYS landing page. If pharmacy owners have not completed and returned any outstanding referred backs prescriptions before this deadline has passed, they will be deleted from system. Pharmacy owners will no longer be able to claim payment for these.
Existing referred back prescriptions held on MYS will be deleted after the 18-month deadline from the date they were first sent to the pharmacy. So pharmacy owners are urged to complete and submit all outstanding referred back prescriptions as soon as possible to avoid any delays in payment.
All paper referred-back forms sent to pharmacies in the post ceased in July 2022 when referred backs became fully digital via MYS. Therefore, pharmacies with any outstanding paper referred-back forms will need to complete and submit these to the NHSBSA no later than the 5th February 2024 (the prescription submission deadline for the dispensing month of January 2024).
Please note that all referred-back prescriptions that have been submitted for payment will be priced using the Drug Tariff for the dispensing month that is currently being processed by the NHSBSA. Delays in the completion of missing information for referred back can affect the timing of payments. This can create potential cash-flow risks for pharmacy owners if very expensive items are referred back, or a large number of items are returned to the pharmacy to complete the missing information. If the submitted information is still insufficient to allow NHSBSA to process the prescription for payment, the item will be re-sent to the pharmacy.
For more information on referred back items please refer to our webpage on Prescription returns and Briefing 020/22: Understanding prescription returns and disallowed items.
Background
Where the NHSBSA cannot process a prescription item for payment due to insufficient endorsed information, it is returned to the pharmacy for the missing information to be added so that it can be correctly reimbursed.
The most common reason why an item is returned is due to an incomplete endorsement, where one or more of the following is missing:
- manufacturer / brand name (if not in Drug Tariff and listed by more than one supplier)
- pack size (if more than one pack size is available)
- price (if NHSBSA does not hold a price for it)
- formulation (commonly seen with handwritten prescriptions for products which are available in multiple presentations).
An item could also be returned if too much information is included in the endorsement, for example more than one manufacturer endorsed.
The NHSBSA apply a coding system to identify up to 19 possible reasons for items being referred back to the pharmacy for further information. Each returned item is assigned a referred back code to indicate the referred back reason.
NHSBSA sends out a notification email to the pharmacy NHSmail account if any new referred back or disallowed items have been generated for the contractor to complete on their MYS account. Pharmacy owners can view any referred back items for completion by checking the ‘Unpaid items’ tab on MYS landing page. Using MYS for receiving digital referred back and disallowed items allows contractor to:
- receive these items sooner and removes the risk of paper returns getting lost in transit;
- provide information required to processes referred back items faster;
- submit a challenge for any disallowed items electronically;
- track the progress of any referred back items throughout until the point they are processed;
- generate monthly reports showing the status of any referred back items.
When the required additional information has been added to the relevant sections within MYS, pharmacy owners can submit referred back items electronically to the NHSBSA for processing.
Related Resources
Community Pharmacy England Briefing 020/22: Understanding prescription returns and disallowed items
Using Your Schedule of Payment to Monitor Performance
