Provider Assurance Pharmaceutical Services

Activities we carry out 

Provider Assurance Pharmaceutical Services supports NHS pharmacy contractors to submit accurate claims for services, including: 

• New Medicine Service (NMS) reviews
• Vaccine services
• Appliance Use Reviews (AURs) - see guidance on submitting your claims for Appliance Use Reviews (Word: 75KB)
• Pandemic Medicine Delivery Service (MDS)

We also support community pharmacies with: 

• the Pharmacy Quality Scheme
• PPE reimbursement scheme
• out of pocket expenses - see guidance about submitting your claims for out of pocket expenses (Word: 265KB)

Post-payment verification (PPV)

Our post-payment verification (PPV) process ensures you’ve been paid the correct amount for the services you deliver. We sometimes review claims to check you haven’t received an overpayment or underpayment. We do this by requesting evidence to substantiate your claims.

PPV process

Your evidence will be reviewed in line with the service specification or Drug Tariff. Once we’ve reviewed your claim, we’ll contact you to let you know one of three outcomes:

1. Payment claims are verified by submitted evidence. No further action is required.
2. We provide best practice feedback and payment claims are verified by submitted evidence.
3. We provide feedback because the evidence provided does not match the submitted payment claims.

If the evidence provided does not match the payment claims, you may:

• let us know the discrepancy is because the advanced service was carried out in a particular month, but not claimed for until a later month. In this case, we will ask you to provide evidence for a different time period (up to 12 months within the financial year)
• accept the evidence does not match the payment claims and agree to a financial adjustment

If any investigation concludes an overpayment has been made, you will receive notification of the payment recovery and will be given the option to appeal.

We share our findings with NHS England and NHS Improvement local teams. Sometimes, the local team might contact you to discuss our findings.

MUR / NMS post-payment verification process (PDF: 108KB)

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