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

Tags: Online learning


Please Note: this course is included in both Operational PDBundle and 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. In the busy pharmacy setting, these issues are usually time-sensitive and can lead to delays or treatment interruptions. This program will provide an overview of various insurance plans that pharmacy professionals may encounter during their daily practice. By using real world examples, participants will learn strategies on how to manage common issues. At the end of the program, participants will feel confident in their 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 menu will provide 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

  • 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


Number of 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

During this program, participants will

Presentation 1

  • Learn about the billing system for medications in community pharmacies 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) 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 a community pharmacy.

Presentation 3

  • Apply information from Modules 1 and 2 to real life examples

Program Completion

To receive a letter of completion for this program, participants must complete the following requirements before May 31, 2020:

  1. Complete the program’s online modules. Instructions will be emailed after registration.
  2. Complete the multiple-choice exam, achieving a score of 70 per cent or higher within a maximum of two attempts.
  3. Complete a program evaluation.

Prerequisites and Target Audience

This program has no prerequisites. This online professional development program was developed for pharmacists, pharmacy technicians, pharmacy students, pharmacy technician students and assistants wanting to feel confident about 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

Cancellation policy: Cancellation requests must be submitted in writing to 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.

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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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