List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.
ELEMENTS | PERFORMANCE CRITERIA |
Elements describe the essential outcomes. | Performance criteria describe the performance needed to demonstrate achievement of the element. |
1. Maintain dispensary computer system. | 1.1.Follow organisational procedures for maintaining computer systems, data and privacy of customer information. 1.2.Interpret and follow technical instructions for computer system maintenance. 1.3.Back up computer data regularly and ensure currency of dispensary and virus protection software. |
2. Monitor and use system information. | 2.1.Update dispensary system data regularly to ensure accuracy and currency. 2.2.Provide clear information to pharmacist about changes to dispensary system data and seek guidance on issues requiring pharmacist instruction. 2.3.Generate, review and distribute regular dispensary reports. 2.4.Identify customer information for follow up in relation to additional services or programs and advise pharmacist. 2.5.Generate documentation that supports pharmacist interactions with customers about services and programs. 2.6.Protect customer privacy and ensure confidentiality of stored information. 2.7.Minimise use of printed materials and maximise electronic transmission and record keeping to reduce waste. |
3. Prepare PBS claims. | 3.1.Follow organisational procedures for administering and reconciling claims. 3.2.Interpret and adapt to changing requirements for claims lodgement. 3.3.Close off prescription claim period, as directed by pharmacist, to meet Medicare Australia and PBS claim deadlines. 3.4.Check prescription forms for patient or agent signature and date. 3.5.Prepare accurate and complete claims. 3.6.Collate prescriptions into patient groups. 3.7.Check serial numbers, identify and refer missing serial numbers to pharmacist. 3.8.Refer completed hard and soft copy claims data to pharmacist for sign-off, and lodge with Medicare Australia. |
4. Reconcile Medicare Australia payments. | 4.1.Analyse and reconcile Medicare Australia payments against data lodged by pharmacy for the claim period. 4.2.Identify and resolve reconciliation discrepancies within scope of own role. 4.3.Identify outstanding payments and refer to pharmacist. 4.4.Identify out-of-period adjustments from prior claims and refer to pharmacist. |
Evidence of the ability to complete tasks outlined in elements and performance criteria of this unit in the context of the job role, and:
complete each of these types of computer maintenance activities:
data back-up
virus software updates
dispensary software updates
dispensary system data updates
generate each of these types of reports:
clinical reports
financial reports
online claims reports
administer and reconcile Pharmaceutical Benefits Scheme (PBS) claims:
prepare and lodge claims for two reporting periods
reconcile payments against claims for two reporting periods
identify outstanding payments and refer to pharmacist across two reporting periods
identify out-of-period adjustments from prior claims and refer to pharmacist across two reporting periods.
Demonstrated knowledge required to complete the tasks outlined in elements and performance criteria of this unit:
role boundaries and responsibilities of dispensary assistants and pharmacists in maintaining dispensary system data and administering and reconciling PBS claims
organisational procedures for:
maintaining computer systems and data
maintaining privacy and confidentiality of customer information
preparing, submitting and reconciling PBS claims
features and functions of dispensary software specifically for:
data maintenance
generating and distributing reports
preparing, submitting and reconciling PBS claims
formats, content and use of dispensary reports, including terminology:
clinical reports
financial reports
online claims reports
types of information generated by dispensary systems to alert pharmacist of customer need or eligibility for additional services or programs, including those related to compliance, and their documentation requirements:
Home Medicine Review
MedsCheck
key features of PBS payment entitlements for different types of customers:
payments for general customers without concessional cards
payments for concessional customers
sources of information and instructions for preparing PBS claims, including those related to:
PBS online
error/rejection messages and how to action
paper-based claims
submission methods
Medicare Australia claims procedures for preparing and submitting online and paper based claim forms
required claim information:
prescription endorsement and identification
serial numbers
price claimed for:
elected PBS prescriptions
exceptional PBS prescriptions
Repatriation Pharmaceutical Benefits Scheme (RPBS) prescriptions for items not included in the PBS or RPBS Schedule.
Skills must be demonstrated in a pharmacy with a designated operational dispensary and administration area. This must be in an industry workplace, which meets Pharmacy Board of Australia and relevant industry standards for dispensary operations.
Assessment must ensure use of:
information technology hardware and software
dispensary software currently used by the community pharmacy industry
online PBS claims systems
template dispensary reports:
clinical reports
financial reports
online claims reports
PBS claims documentation
endorsed prescriptions with stickers or stamps, ready for claiming
organisational procedures for:
maintaining computer systems and data
maintaining privacy and confidentiality of customer information
preparing, submitting and reconciling PBS claims
pharmacists with whom the individual can interact
assessment activities that allow the individual to work with commercial speed, timing and productivity to complete PBS claims within nominated deadlines.
Assessors must satisfy the Standards for Registered Training Organisation’s requirements for assessors, and:
have worked in the pharmacy sector for at least two years.