PHARMPOWER BOOST

Do you get stressed when managing drug insurance plans?‍ ‍We can help.

• PharmPower is your expert resource for mastering all things related to drug insurance plans in Canada.

Our Fundamentals of Drug Insurance Plans in Canada course is based on many years of practical community practice experience and is designed for everyone including pharmacists, pharmacy technicians, pharmacy assistants and prospective pharmacy job applicants.

Our asynchronous course consists of 6 e-learning modules with voice-over audio that can be completed in under 4 hours, or at your own pace.

Module 1: Introduction to Insurance Plans (30 minutes)

• Discuss the various public and private insurance plans.

• Discuss the reimbursement structures for patient drug plans and pharmacy.

Module 2: Third Party Private Insurance Plans (30 minutes)

• Enter a drug insurance plan using the card presented by the patient.

• Identify restrictions on insurance plans, including prior authorization and exclusions.

Module 3A: Ontario Drug Benefit Groups (40 minutes)

• Identify the groups covered under the Ontario Drug Benefit, and whether they have a deductible or copayment.

• Bill an Ontario Drug Benefit patient using their health card based on the eligibility group.

Module 3B: Ontario Drug Benefit Drugs (30 minutes)

• Determine if a medication is a benefit, non-benefit or limited use benefit using the formulary.

• Identify restrictions on insurance plans, including limited use codes and devices.

Module 3C: Ontario Drug Benefit Special Services (20 minutes)

• Identify which services are covered to all Ontarians with a valid health card.

• Identify which services are only covered for Ontario Drug Benefit patients.

Module 4: Federal Insurance Plans (20 minutes)

• Identify which plans fall under federal jurisdiction and their plan design.

• Enter a federal drug insurance plan using the correct card or document.

Module 5: Adjudication and Intervention Codes (40 minutes)

• Interpret common rejection messages and manage adjudication issues.

• Use intervention codes effectively and appropriately with supporting documentation.

Module 6: Audit Risk Mitigation (30 minutes)

• Identify high-risk areas for audits and how to mitigate clawbacks

• Discuss what documentation is required to support claims and intervention codes.

Make your effort count by choosing PharmPower today!  With our course, you can impress your pharmacy colleagues and improve your work efficiency!