New Zealand Gazette – 2001 – No. 44

Page 995

✨ Pharmaceutical Transaction Guidelines



27 APRIL
NEW ZEALAND GAZETTE
995

Non Claim Transactions

  • If the item is not to be charged to the Ministry of Health, or is not being reprocessed, the transaction is to be specified with a [Transaction Category] = “N” for Non Claim.
  • All data elements to be included in the transaction record of the claim file, following the same rules as a Standard Claim.

Resubmitting Transactions

  • Transactions may be resubmitted for any of the following reasons:
    • transaction field contents have changed
    • only items that have been submitted with incorrect data should be resubmitted
    • items that have been rejected by the system do not need to be resubmitted through this procedure
    • if a transaction is resubmitted, the resubmission must be transferred as two transactions.

1st Line
The first transaction needs to have a [Transaction Category] = C, for Credit. This need only contain data elements defined for Credit Transactions, as above.

2nd Line
The second transaction needs to have a [Transaction Category] of “R” for resubmission.

All data elements need to be submitted in the 2nd line of a resubmission following the same rules as a Standard Claim, noting the following criteria.

Field No Name Notes
12 Unique transaction number Must be the [Unique Transaction Number] of the new transaction in the Pharmacy system if data has changed. (Refer [Unique Transaction Number] for further explanation.)

Owed Balance Transaction

  • The quantity remaining still to be claimed from a previously claimed transaction.
  • Transaction Category O will allow payment to be made for the quantity of the pharmaceutical but no associated fees.
  • The [Prescription ID Suffix] must be the same as the original transaction where the balance owing completes the quantity prescribed.


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Online Sources for this page:

VUW Te Waharoa — PDF NZ Gazette 2001, No 44


Gazette.govt.nz — PDF NZ Gazette 2001, No 44




✨ LLM interpretation of page content

🏥 Transaction Record Detail (continued from previous page)

🏥 Health & Social Welfare
27 April 2001
Pharmaceutical Claims, Non Claim Transactions, Resubmission, Transaction Categories, Audit