The WCB can authorize a pharmacy to direct bill the WCB for a worker’s medication. Learn about accreditation, authorization to treat, billing and payments.
The WCB can authorize a pharmacy to directly bill the WCB for a worker’s medication. The authorization provided to the pharmacy will specifically identify the type of medication the WCB will cover.
Pharmacists are encouraged to access the Pharmaceutical Information Program (PIP) at www.ehealthsask.ca prior to issuing prescriptions to WCB clients, to avoid duplicate issuance.
To prevent hardship to a WCB customer, bill the WCB directly for approved prescriptions.
The WCB should be billed for the total amount of the prescription cost. Please do not bill a third party for any portion of the approved prescription.
Please see the below quote, taken directly from Saskatchewan Health – Program and Services website:
Residents whose health services are covered under existing federal programs through First Nations and Inuit Health, Health Canada, Department of Veteran Affairs, Workers’ Compensation and federal penitentiaries are not eligible for Drug Plan benefits from Saskatchewan Health.
Payment can only be issued if the invoice meets our criteria. The following information is required:
- worker’s name
- worker’s address
- Provincial Health Number (PHN)
- date of birth
- prescription fill date*
- care provider number
- pharmacy name
- pharmacy address
- pharmacy store number (if applicable)
- pharmacy phone and fax number
- prescription amount(s)
- invoice total
*Note: Please only include one month per invoice.
If the WCB receives an application for payment after a 12-month period from the time the medical aid is provided to an injured worker, the WCB will not pay any account rendered by a physician, surgeon, hospital or other health care professional or institution. See WCB procedure, Medical Aid Billings – Payment (PRO53/2006).
Keep a daily record of the service you provide to our customers in case an audit is required.
The WCB issues payments to care providers weekly and provides statements to confirm the payments were issued. These statements may include explanatory codes, to provide details regarding specific services.
- All work-related injuries requiring medical aid are reported promptly.
- All treatment is necessary and consistent with established agreements.
- All invoices accurately reflect the services provided.
- The employer and worker are aware of current restrictions to allow early return to work.
When treating WCB customers, pharmacists will:
- Access the Pharmaceutical Information Program (PIP) at www.ehealthsask.ca prior to issuing prescriptions to WCB clients to avoid duplicate issuance.
- Get approval on a file-by-file basis before treating WCB customers.
- Show ethical practice standards on a day-to-day basis. This includes informing any prospective WCB customer of business relationships you may have with their employer, so the worker can decide whether they want to choose you as a care provider.
- Avoid mentioning in either your clinic’s advertisements or personal advertisements that you treat WCB customers or you are affiliated with the WCB in any way.