Claiming Immunisation Administration Fees

The process for claiming funded vaccines available to community pharmacy changed from 1 August 2023 (see: Immunisation and Co-Administration Fees). These changes may have resulted in claiming issues.

Troubleshooting

On finding errors in a claim for any of the immunisation administration fees, please check the following:

Immunisation Administration Fees Not Paid

1. Check Medicine Stock Cards

If immunisation administration fees have been dispensed but not paid:

• Check that Fee has not been ticked on each of the fees' medicine stock cards:
  • IMMUNISATION ADMIN FLU Fee (pharmacode 2660733)
  • IMMUN CO-ADMIN FLU & SHINGLES Fee (pharmacode 2664453)
  • IMMUN ADMIN ALL OTHER VACCINES Fee (pharmacode 2692813) 

Do NOT tick the Fee tick-box on any immunisation administration fee.

• If the fee stock card is as pictured above:
  • Untick Fee and remove Fee from Class.
  • Reset the Pack size to 1.
  • Press F12 Accept Details to save the changes.

2. Find Unpaid Administration Fees

For each of the three immunisation administration fees: 

• • Create a list of all the fees dispensed using the Prescription Details report.
    • Go to 3. Reports, 2. Prescription reports, then 2. Prescription details.
    • Enter a date range, e.g. set the Start date to 01/08/2025 and End date to today's date.
    • Enter the administration fee in Select medicine.  
      • Note: Each pharmacode will need to be reported on separately.
    • Tick Include Prices and press F8 No Pat. Details (to remove unnecessary patient information).
    • Press F12 Accept Details to run the report and F5 Csv File to save it.
  • Note: Ensure the Load Days of the Dispensary program cover from August 2023. If not, change them as described in Load Day.
    
    
  • Using a spreadsheet application such as Excel, open the file (saved to C:\Toniq Users\Exports) to create a list of unclaimed fees.
    • Scroll across the spreadsheet to the Subsidy column.
    • Press the Sort & Filter option on the toolbar and select Filter.
    • Press the down arrow box next to Subsidy and make it so that only the 0 box is ticked:
      
      
      
  • Alternatively, administration fees that have not been paid may be found using F6 Med Log in the stock card. These can be identified by the fact that they do not have a contract number before the stock point in the CT/SP column:
    
    
    • Note: The Med Log cannot be printed, so the script numbers must be noted down manually.
       

3. Reprice Unpaid Administration Fees to be Subsidised

The claiming system will reject claim items more than 120 days old. Toniq recommends discussing next steps for potential payment of the unpaid fees with your portfolio manager.

Tip: If you have been requested to submit a claim with only Immunisation Administration fees, create a new claim (but do not send it) before repricing is done. Delete this unsent claim after the administration fee claim has been created.

• • Reprice each script listed as having a $0 Subsidy in the report above.
    • Edit the scripts using F2 View/Edit then F2 Edit Rx.
    •  Re-enter the Quantity to get Toniq to recalculate the fee for subsidy:
      

Note: If the number of claim items that need to be repriced is significant, please contact Toniq Support to run a utility to do this in bulk. It requires the Toniq Super-Password (Toniq staff: see Reprice scripts).

4. Claim the Unpaid Administration Fees

• Before creating the claim, change the Days to Check Back to cover all the priced scripts:
  • From the main menu, go to 4. Electronic claiming, 3. Claim options / Certificates, and press the space bar to select the required contract.
  • Edit the Days to Check Back to the required number of days, e.g. 885.
    • Note: If the claim is created in 2025, 885 will go back at least to 1 August 2023, when the Immunisation Administration Fees were introduced.
      
  • Press F12 Accept Details to save the new setting.
    
    
• Create a new claim with the new settings:
  
  
  • The edited scripts will automatically go into this claim.
  • Note: Depending on the number of claim items repriced and the number of Days to check back, it may take a long time for the claim to be created and sent. It is recommended that these steps are taken on the best PC at the pharmacy (usually the server).
    
    
• Remember to go back into Claim Options (as described above) to reverse the Days to Check Back to what they were before, e.g. 120 days, so that the next claim created will be correct.

Immunisation Fees Not Dispensed

Since August 2023 an Immunisation Administration Fee needed to be dispensed for each funded vaccination (other than Covid vaccinations). (See Immunisation and Co-Administration Fees.) If this has not been done, or if it is suspected that some have been missed:

• Run a Bulk edit patients report (9. Other > 2. Bulk edit patients).
• Select a Period (can use F3 Date Range), set Items to 1, and select the Medicine (e.g. Influvac Tetra 2024), and press F12 Accept Details.
  • This results in a list of all the patients in that date range who have had that vaccination.
• From the resulting list, remove all the patients who had the Immunisation Administration Fee dispensed:
  • Press F2 Edit list and select Remove patients in bulk.
  • Reselect the Period as above and set Items to 1.
  • Select Immunisation Administration Fee as the Medicine and press F12 Accept Details.
• Then remove scripts dispensed with an NS script code:
  • Press F2 Edit list and select Remove patients in bulk.
  • Reselect the Period as above and set Items to 1.
  • Set Rx code to NS and press F12 Accept Details.
• Use this list to go back to the patients and dispense an Immunisation Administration Fee, but remember to:
  • check that the vaccination was subsidised (it may have been dispensed NS under an A4 script code), and to
  • change the date of the Immunisation Administration Fee back to when the vaccination was dispensed.
•  These fees will go into the next claim created.

Variations in the Claim

• If there is a discrepancy between what Toniq has calculated and what is paid according to the claim answerback, please check that correct contract pricing has been set in Dispensary. 
  • See: Updating Pricing to Latest ICPSA Contract
  • Note: Influvac Tetra 2024 prices at $13.81. If this is what your system calculates, then your pharmacy's Price Parameters have been updated. 
• The claiming system will always pay per the latest/correct pharmacy contract, so even if the contract has not been updated in Toniq, Te Whatu Ora's calculations will be correct.

See also:

• Immunisation and Co-Administration Fees
• Vaccination Immunisation Administration Fee Gross Profit Reporting
• Flu Vaccinations 2025
• Flu Vaccinations 2024 - Webinar

Reviewed: 07/07/25