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Vaccination and Administration Fee Claiming

Astrid Saville
  • Updated

The process for claiming funded vaccines available to community pharmacy changed from 1 August 2023. Specifically, the administration service fee will no longer be part of the subsidy calculation of the vaccine's dispensing in the claim, and an administration fee will need to be dispensed. See: Immunisation and Co-Administration Fees. 

For more information, download the Planning Guide: funded vaccines in community pharmacy or visit the Immunisation Advisory Centre webpage.

 

Troubleshooting

On finding errors in a claim regarding vaccinations or the Immunization Administration (or Co-administration) Fees, please check the following:

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. 
  • 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.

Immunisation Administration Fee Not Paid

  • If Immunisation Administration Fees have been dispensed but have not been paid, check that the Fee tick-box has not been set on the medicine stock card.

Do NOT tick the Fee tick-box on the Immunisation Administration Fee.

  • If the Fee tick-box has been set as pictured above:
    • Untick it and reset the Pack size to 1.
    • Create a list of all Immunisation Administration Fees that have been dispensed since ticking Fee using the Prescription Details report (3. Reports > 2. Prescription reports > 2. Prescription details).
    • Search for each script that has not been paid, edit it (using F2 View/Edit then F2 Edit Rx) and re-enter the Quantity (or use F10 Other > NSS quantity > 0) to get Toniq to re-calculate the fee to be subsidised.
    • The edited scripts will then go into the next claim created.

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.

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