Community Pharmacy – Universal Claim Framework (UCF)

What is the Universal Claim Framework (UCF)?

UCF supports electronic claims for reimbursement for the following pharmacy-led services:

Unscheduled Care
Emergency Hormonal Contraception
Smoking Cessation (including Varenicline)
Healthy Start Vitamins
Gluten-Free Food Service
Meningitis B Prophylaxis
Urinary Tract Infections
Impetigo

For these services, the handwritten CPUS Form is replaced with an electronic claim message and a form printed on the new CP4/3 stationery in the pharmacy.

CP4/3 Forms

For the UCF services outlined above, the PMR system, once enabled, will print all the necessary details on the CP4/3 form, and, more importantly, include them within the electronic message for reimbursement. This means you do not handwrite any codes or endorsements on the form.

The forms for the Minor Ailments Service (MAS) will also be printed on the new CP4/3 stationery – this includes registrations, withdrawals, consultation only and MAS prescriptions.

MAS forms still need to be sent to Practitioner and Counter Fraud Services (PCFS) to confirm patient eligibility for the service. However, forms for UCF services do not need to be submitted to PCFS. There will be a prompt printed in the bottom left hand corner of the CP4/3 forms which will remind you what to do with them.

All PMR systems will default to printing CP4/3 forms for all UCF services outlined above as it is expected the forms will still be used to support the dispensing and checking process and may also be sent to the GP where appropriate.

If you want to disable the printing of UCF forms, please contact your ePharmacy Facilitator or your PMR Helpdesk.

Service Fees and Payments

Monthly Claims Forms should still be sent to Carol Droubay or PCFS as appropriate. More information can be found on this website under the relevant service.

Important Points:

Reimbursement for UCF services is based on the electronic claim message

Service fees for UCF services are claimed in the usual way

CP4/3 Forms for UCF services do not need to be sent to PCFS

CP4/3 Forms for MAS should still be sent to PCFS

You must have robust PMR housekeeping arrangements in place – this will ensure all UCF claims leave your PMR system and are received by ePharmacy for reimbursement

In order to build the electronic claim, make sure your patient records are up to date within your PMR to include the CHI number (use lookup on PCR if necessary) and GP Practice code. If you don’t know the practice code then you must look it up using the GP practice list (scroll down to the Blue section ‘Patient Group Direction for Urgent Provision of Repeat Medicines and Appliances’ and click on the Microsoft Excel link) and add it to the patient’s PMR record before you will be able to send the electronic claim.

All other pharmacy-led services for which a CPUS form is currently required should continue to be operated in the usual way, using a handwritten CPUS Form e.g. COPD and the Pharmacy First Extension service

Unused CP2/3 forms should be returned to the ePharmacy Facilitator at the time of enablement – these will be re-used until the end of March 2018 within pharmacies that are not enabled

Universal Claim Framework (UCF)

What is the Universal Claim Framework (UCF)?

CP4/3 Forms

Service Fees and Payments

Important Points:

Further Reading