What is an STC?
STC stands for Special Type Consultations. An STC form is filled in to claim payment for a patient’s treatment by the doctor who falls outside the normal capitation payment. Either the doctor or administrative staff can fill in the form.
A code is entered on the form to specify what service is being claimed. Payment is made by the HSE – Primary Care Reimbursement Service.

What is the form used for?

  • Out Of Hours Claims: Where a General Practitioner treats a patient outside the normal surgery hours.
  • Temporary Patient: An eligible person who is normally a resident in an area not serviced by the General Practitioner, but has moved temporarily. If the persons stay at the temporary residence extends to more than three months he/ she will cease to be regarded as temporary.
  • Emergency Patient: An eligible person who is unable to receive treatment at that time from the General Practitioner on whose panel he/ she is included, or from his/ her deputy.
  • Visiting From Another Country: Residence with established eligibility from one of the other member states of the European Union, European Economic Area or Switzerland can obtain the necessary healthcare in the public system if they become ill or injured while on a temporary stay in this country.
  • Special Services: Services provided by the doctor which are not covered directly by the medical card.

Codes for filling in the form
Firstly the patients name, address & medical card details are entered.
The doctors’ details are then entered.
Patient/ Patient’s representative are required to sign the form.
The first box requires an STC Code which could be any of the following:

               T= Temporary Patient
              E= Emergency Patient
              C= Visiting from another country
              H= Out of hours

The claiming date is entered beside the above.
The next box requires a location code. The location could either be in the practice or at the patient’s home:

               S= Surgery
              D= Domiciliary

The distance code is entered, distance between the patients home and the surgery and is required if claiming under the out of hour’s code.

               A= 0 – 3 Miles
              B= 3 – 5 Miles
              C= 6 – 7 Miles
              D= 7 -10 Miles
              E= Over 10 Miles

The time that the patients consultation took place needs to be entered into the following box, (see next page) the consultation will be either: Day, Late or Night times. This is only required if claiming under the out of hours code.

               D= Day between 08:00 – 20:00
              L= Late between 20:00 – 24:00
              N= Night between 24:00 – 08:00
              A= Additional (more than one medical card patient seen on visit).

The last code box requires a code for the special service provided. This box is used if a patient’s consultation requires a special service either during normal working hours or out of hours.

The claiming doctor is required to sign the form on the bottom left hand corner along with the practice stamp.

The final stage of the form requires information if the patient has been given a vaccination. All the correct details should be entered into the correct place.

NOTE: The General Practitioner must have completed in the first instance a Special Type Services registration form indicating the special services that he/ she provides, which is submitted to the Primary Care Unit on taking up the GMS contract. This form is then forwarded by the Primary Care Unit to the Primary Care Reimbursement Service for their data base. If a claim is made by the General Practitioner for a service which has not been registered the claim will be rejected.

GP Registration forms for STC can be obtained from the Primary Care Unit.


GP Claiming Procedures
When claiming for an STC each category must be clearly entered into the appropriate spaces of the GP STC claim form. A supply of STC claim formscan be obtained from the Primary Care Unit. The patient / Patient’srepresentative are required to sign the form.
There are two types of claiming procedures: Manual or Electronic (see next page).

Claims should be submitted to the HSE – Primary Care Reimbursement Service before the 7th of each month for payment on the 15th of the following month.

Claims received after the 7th of the month will not be processed for payment until the following month. The fee payable in respect of each STC is made up of a number of elements, which is why it is essential that all details are filled in correctly on the claim form.


Manual Claims
All claims must be posted to the Primary Care Reimbursement Service in time for deadline for payment as stated over.
The top copy of the STC form is sent to the HSE – Primary Care Reimbursement Service for payment and the bottom copy (green) part is retained by the practice as evidence of the claim.
All codes must be entered correctly into the appropriate spaces provided.

Manual STC Form

 


Electronic Claims

Electronic claims can be made by making an application in writing to the HSE – Primary Care Reimbursement Service to receive a password and username.

Claims can then be processed via the internet by logging onto the following:
https://hse.sspcrs.ie/doctor
The computer will prompt you to insert relevant codes.