Nobody audits your NHS income for you

Your largest customer calculates its own bill, applies its own deductions, and pays. There is no purchase order to match, no remittance to query line by line, and no supplier statement reconciliation of the kind every other business runs. If a claim is under-paid, the only person who will ever find it is you or somebody you ask to look.

What we check

The 180-day hard stop
EREMs sent later than 180 days after the Dispense Notification are not paid. This is the one deadline in the cycle with no remedy behind it.
After the 5th, before the cut-off
The advance slips a full month and a £25 administrative deduction may apply. After the published cut-off there is no advance at all and payment waits for reconciliation.
Worth knowingThe deduction scale is still in operation. It reduces reimbursement on the assumption that you buy below Drug Tariff price, and it applies whether or not your terms achieve that. Sizing the gap converts a vague sense of being squeezed into a number you can take into a wholesaler negotiation.

Common questions

What is actually being checked?

The FP34 schedule you submitted against what NHSBSA paid. Item counts, the Single Activity Fee at £1.52, the advanced service claims you made — including Pharmacy First — and the deductions applied on the way through. The purpose is to find the difference between what you claimed and what arrived, because nothing in the system tells you when that difference exists. There is no supplier statement to reconcile and no remittance you can query line by line, so the check has to be built rather than requested. We do it month by month, because a discrepancy found within the cycle can often still be corrected, and one found a year later usually cannot.

How can a submission be paid at less than it is worth?

Several ways, and none of them look like an error. EREMs sent after the 5th are priced with next month's claim. Sent later than 180 days after the Dispense Notification they are not paid at all. Submitted after the 5th but before the cut-off, the advance slips a whole month and a £25 administrative deduction may apply. After the published cut-off there is no advance for that month and payment waits for reconciliation. Each is a rule rather than a mistake, which is exactly why nobody flags it.

Is the deduction scale still in operation?

Yes. It reduces your reimbursement on the assumption that you buy below Drug Tariff price. The assumption is applied whether or not your buying terms achieve it, so a contractor without the purchasing power of a large group carries the gap. Quantifying that gap is one of the more useful things a review produces, because it converts a vague sense of being squeezed into a number you can take to a wholesaler negotiation. It is also the figure that tells you whether joining a buying group would actually pay for itself, rather than assuming it would.

What can realistically be recovered?

It depends entirely on what the checking finds, and any adviser who quotes you a recovery figure before looking is guessing. What is reliable is the pattern: unclaimed or under-claimed advanced services, item count discrepancies, and submissions that slipped a cycle. We will tell you what we find and what is worth pursuing, including when the answer is nothing. Some discrepancies cost more in time to chase than they return, and saying so is part of the job — a review that always finds something worth paying us to recover would not be a review, it would be a sales process.