Billing 101: Ontario Drug Benefit (ODB) and Third-Party Insurance

Tags: Online learning

 

OVERVIEW
Please note that this course is included in both Operational PDBundle & PD Pharmacy Technician Bundle.

When entering prescriptions in a community pharmacy, pharmacists and pharmacy staff often encounter adjudication issues with ODB or third-party insurance. These issues are usually time sensitive in the busy pharmacy setting, and potentially lead to delay or interruption of treatment. This program will provide an overview of various insurance plans that pharmacy professionals may encounter during their daily practice and teach participants how to manage such issues as they arise. Also, the program will introduce real examples of common issues and how they are solved. At the end of the program, the participant will feel confident in his or her knowledge of the adjudication system and will be able to resolve the most commonly encountered billing issues.

 

How to register: To register, please scroll to the bottom of the page and click on “Pricing and Registration”. A drop-down will open with pricing information for members and non-members*. Select the option that applies to you, then click on "add to cart" to start the registration process.

 

*Not a member? OPA members receive significant discounts on professional development. Find out how to become a member here.

 

If you’re a pharmacist, you may be eligible for funding from the Allied Health Professional Development Fund (AHPDF). Click here for more information, and to apply.

 

Program outline

This program consists of the following modules:

 

  • Module 1: Pharmacy Billing and Ontario Drug Benefit (ODB)
  • Module 2: Third Party Insurance
  • Module 3: Case Examples of Billing
  • Declaration of Completion – 2019 Billing 101: ODB and Third-Party Insurance
  • Final Exam – 2019 Billing 101: ODB and Third-Party Insurance
  • Program Evaluation – 2019 Billing 101: ODB and Third-Party Insurance

 

Continuing Education Units:

This program is not CCCEP accredited. CEUs will not be granted.

 

Course Availability:

You must complete the program before May 31, 2020.

 

Learning Format: 

  • Online learning modules with case studies (3-5 hrs)

 

Learner Assessment:

  • Multiple choice assessment

 

Learning objectives

Upon completion of this program, participants will be able to:

 

Presentation 1

  • Learn about the billing system for medications in community pharmacy in Ontario
  • Understand the Ontario Drug Benefit (ODB) program and its compositions
  • Review several programs provided by ODB
  • Understand how to troubleshoot common adjudication issues

 

Presentation 2

  • Describe the relationship between patient, pharmacy and third-party insurance providers
  • Outline three third party insurances (Greenshield, Express Scripts, Telus Assure) that are commonly billed in community practice
  • Understand the Non-Insured Health Benefit (NIHB) program and its formularies
  • Recognize pay-assist cards and how to obtain and apply them
  • Review other common programs that can be billed in community pharmacy

 

Presentation 3

  • Apply information from modules 1 and 2 in real life examples

 

Program Completion

To receive the letter of completion for this program, participants will be required to complete the following requirements before May 31, 2020: 

1.      Complete the program’s online modules (instructions will be emailed to you separately after registration).

2.      Complete the multiple-choice exam and achieve a score of 70 per cent or more within a maximum of two attempts.

3.      Complete the program’s evaluation.

 

Pre-requisites and Target Audience

There are no pre-requisites for this program. This online professional development program is developed for pharmacists, pharmacy technicians, pharmacy students, pharmacy technician students and assistants who would like to feel confident how to bill prescriptions using various insurance plans.  

 

Subject Matter Experts: 

  • Somin Park, RPh (BScPhm)
  • Allan Choi, RPh (PgDip, BScPhm, BScMRS)
  • Nathan Mapp, Pharmacy Assistant

 

Last updated: May 2, 2019

Inquiries: Please contact OPA’s professional development team by phone at 416-441-0788, option 3 (toll-free in Ontario at 1-877-341-0788, option 3), or by email at education@opatoday.com.

 

Cancellation policy: Requests for cancellations must be submitted in writing to education@opatoday.com no later than five days after access to the program has been emailed to you. A $30 (+HST) administration and processing fee will apply. Cancellations will not be permitted once log-in to access the program material has been initiated. Program registration fees will not be refunded after the cancellation deadline.

 

Protecting your privacy: Your privacy is important to us. Some information you provide to OPA in program registration forms and exercises may be considered personal information. OPA collects, uses, and shares the information contained in program registration forms and exercises for the sole purposes of processing your registration, issuing certificates/letters of completion, awarding continuing education credits, and delivering OPA services, programs, and publications to you.

 

Learners’ code of conduct: By registering for an OPA education program, you agree to follow OPA’s Learners’ Code of Conduct. For further details click here

Event Date: Recurring | City: Online | Venue: Online

Pricing and Registration
Member Rate
2019Bill101ODB   $75.00 Add to Cart 
Non-Member Rate
2019Bill101ODB   $150.00 Add to Cart 
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