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Direct billing on paper invoices
Electronic billing through Pharmacy Benefits Management
Program
Direct billing on paper invoices
Paper invoices must include:
- Pharmacy information: Name, address, payee number
- Worker information: Name and WorkSafeBC claim number
- Prescription and medical supply information: Doctor's name, dates of service, names of drugs or medical supplies, quantities, costs and fees
One invoice must be submitted for each worker. If an injured worker has more than one claim number, a separate invoice must be submitted for each claim number.
Send invoices to:
WorkSafeBC
Payment Services Department
PO Box 94460 Station Main
Richmond, BC V6X 8V6
To check the status of an invoice payment from WorkSafeBC online, go to Check invoice payment status.
GST/PST
As a service provider or supplier to WorkSafeBC, it's your responsibility to determine if the services and/or goods you supply to our organization are subject to these taxes. WorkSafeBC will be subject to both GST and PST after April 1, 2013.
If you invoice WorkSafeBC for GST or PST, please note:
- If applicable, indicate your GST or PST registration number in the invoice;
- If tax is applicable, the application of GST and PST (after April 1, 2013) will be determined by date of invoice, not date of service;
- The taxes must be indicated per line item on your invoice. The indication can either specify the tax amount or be labeled with a clear "indicator" (e.g., a checkmark) that shows whether GST or PST tax is applied to this line item or not;
- If you do not indicate the tax per invoice line item, but instead include a cumulative tax amount, your invoice will be returned to you unpaid, with an explanatory letter requesting that you correct and re-submit your invoice to reflect appropriately directed tax amounts.
If you have any questions about the invoice requirements noted above, please email PYMTTAXINQ@worksafebc.com. Please note that WorkSafeBC is not able to provide advice regarding the taxability of goods or services, or the application of the GST or PST. For additional or specific information about the taxes, please contact your accountant, a tax professional, or the relevant government agency.
Electronic billing through Pharmacy Benefits Management Program
The Pharmacy Benefits Management (PBM) Program is administered by Telus Health Solutions (Emergis/Assure Health). Injured workers who are eligible for the program are issued a Pharmacy Benefit Card allowing for direct billing. The card will only cover medications related to the claim number listed on the card. The card will not cover medications related to other WorkSafeBC claims.
WorkSafeBC will pay 100% of the acquisition cost of the drug and the professional fee up to $12.00. WorkSafeBC generally follows policies and practices set out by Pharmacare with regard to days-supply and drug pricing.
Our policies and practices are as follows:
- Maximum 30 day supply for short-term drugs (i.e., opioids)
- Maximum 100 day supply for maintenance drugs
- WorkSafeBC follows the suggested maximum quantities for certain medications (i.e., erectile dysfunction, migraine medications) as set out by Emergis. Please refer to page 24 of your Emergis Pharmacy Manual for a complete list of medications with monthly maximums.
- Generic drugs only unless brand name drugs have been specifically requested by physicians by indicating "No substitution" on the prescriptions
- Drug prices are capped at the actual acquisition costs. Drug pricing is based on both Pharmacare's drug file and the McKesson Pharmaceutical Wholesaler's drug file. No amount greater than this may be billed. Any further surcharge against WorkSafeBC, the patient’s employer, or, the patient is not permitted as per your agreement with Emergis.
- If you have questions concerning ingredient costs, please call the Telus Health Solutions (Emergis/Assure Health) Pharmacy Support Centre at 1 800 668-1608 and ask to have one of the pharmacists call you. In the event that your actual ingredient acquisition cost exceeds the amount allowed by the Emergis system, please contact the Emergis Pharmacy Support Centre and fax the most recent invoice to them at 905 602-7411.
- Compounds: WorkSafeBC follows Telus Health Solutions guidelines for eligibility and pricing as outlined on p. 25 of your Emergis Pharmacy Manual. If there is any uncertainty please contact the Telus Health Solutions Pharmacy Support Centre prior to compounding.
- Professional fee is capped at $12.00
As WorkSafeBC is the primary payer of injury-related medications, prescriptions must be sent to Pharmacare with the DE intervention code so that the DUR process can take place without adjudication. The prescriptions, with the DE intervention code, can be then sent to Emergis for adjudication.
For more information on how to process prescriptions through the Pharmacy Benefit Card, please refer to the Emergis/Assure Health Pharmacy Manual.
For information on how to enter the DE intervention code or overriding for brand name drugs, please contact your software vendor.
For more information
If you have questions regarding billing or payment, contact the WorkSafeBC Payment Services Department at 604 276-3085 or toll-free at 1 888 422-2228.