Avoiding delays when you claim

Please provide complete and accurate information in PBS claims to ensure we can pay you as quickly as possible.

We need you to include the relevant prescription documents for each pharmaceutical benefit item you claim. You must keep prescription documents in electronic or paper form for 2 years.

When you enter information, make sure:

  • you record the patient's PBS or RPBS eligibility correctly using either their Medicare or repatriation card number, or concession or safety net card number
  • you enter the correct prescriber number and date of prescribing when dispensing
  • for owing prescriptions, the date you called the prescriber is the actual date of dispensing, not the date on the prescription form or the date the prescription was received.

When closing a claim through your prescription dispensing software, make sure you:

  • reconcile prescriptions in the actual prescription claim against the 'missing script' report
  • delete prescription serial numbers from the computer claim for uncollected or missing prescriptions
  • re-serialise prescriptions that are present but listed as missing
  • check both the approval number and claim period number are valid
  • ensure an authorised person completed the certification of supply statement
  • use the 'Close a Claim' transaction to send the claim to us for processing.
Page last updated: 10 December 2021.
QC 47261