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Evidence Guide: SIRCDIS007 - Administer dispensary computer systems and claims

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

SIRCDIS007 - Administer dispensary computer systems and claims

What evidence can you provide to prove your understanding of each of the following citeria?

Maintain dispensary computer system.

  1. Follow organisational procedures for maintaining computer systems, data and privacy of customer information.
  2. Interpret and follow technical instructions for computer system maintenance.
  3. Back up computer data regularly and ensure currency of dispensary and virus protection software.
Follow organisational procedures for maintaining computer systems, data and privacy of customer information.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Interpret and follow technical instructions for computer system maintenance.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Back up computer data regularly and ensure currency of dispensary and virus protection software.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Monitor and use system information.

  1. Update dispensary system data regularly to ensure accuracy and currency.
  2. Provide clear information to pharmacist about changes to dispensary system data and seek guidance on issues requiring pharmacist instruction.
  3. Generate, review and distribute regular dispensary reports.
  4. Identify customer information for follow up in relation to additional services or programs and advise pharmacist.
  5. Generate documentation that supports pharmacist interactions with customers about services and programs.
  6. Protect customer privacy and ensure confidentiality of stored information.
  7. Minimise use of printed materials and maximise electronic transmission and record keeping to reduce waste.
Update dispensary system data regularly to ensure accuracy and currency.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Provide clear information to pharmacist about changes to dispensary system data and seek guidance on issues requiring pharmacist instruction.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Generate, review and distribute regular dispensary reports.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify customer information for follow up in relation to additional services or programs and advise pharmacist.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Generate documentation that supports pharmacist interactions with customers about services and programs.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Protect customer privacy and ensure confidentiality of stored information.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Minimise use of printed materials and maximise electronic transmission and record keeping to reduce waste.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare PBS claims.

  1. Follow organisational procedures for administering and reconciling claims.
  2. Interpret and adapt to changing requirements for claims lodgement.
  3. Close off prescription claim period, as directed by pharmacist, to meet Medicare Australia and PBS claim deadlines.
  4. Check prescription forms for patient or agent signature and date.
  5. Prepare accurate and complete claims.
  6. Collate prescriptions into patient groups.
  7. Check serial numbers, identify and refer missing serial numbers to pharmacist.
  8. Refer completed hard and soft copy claims data to pharmacist for sign-off, and lodge with Medicare Australia.
Follow organisational procedures for administering and reconciling claims.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Interpret and adapt to changing requirements for claims lodgement.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Close off prescription claim period, as directed by pharmacist, to meet Medicare Australia and PBS claim deadlines.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check prescription forms for patient or agent signature and date.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Prepare accurate and complete claims.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Collate prescriptions into patient groups.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Check serial numbers, identify and refer missing serial numbers to pharmacist.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Refer completed hard and soft copy claims data to pharmacist for sign-off, and lodge with Medicare Australia.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Reconcile Medicare Australia payments.

  1. Analyse and reconcile Medicare Australia payments against data lodged by pharmacy for the claim period.
  2. Identify and resolve reconciliation discrepancies within scope of own role.
  3. Identify outstanding payments and refer to pharmacist.
  4. Identify out-of-period adjustments from prior claims and refer to pharmacist.
Analyse and reconcile Medicare Australia payments against data lodged by pharmacy for the claim period.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify and resolve reconciliation discrepancies within scope of own role.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify outstanding payments and refer to pharmacist.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Identify out-of-period adjustments from prior claims and refer to pharmacist.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

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.

Required Skills and Knowledge

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.