Pharmacists

 

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How to invoice the TAC

The TAC and WorkSafe have aligned their pharmacy policies to simplify invoicing processes and requirements for pharmacists. Complying with the revised requirements will enable prompt processing and payment of your accounts by ensuring you can correctly invoice the TAC and WorkSafe.

The TAC and WorkSafe can only pay for pharmacy items to treat a transport accident or work-related injury or illness that have been prescribed or requested by a medical practitioner.

'Over the Counter' (OTC) items must be requested by a medical practitioner, but a copy of the script is not required to be sent to TAC or the WorkSafe Agent. The request may be in the form of a prescription or message on letterhead requesting the treatment of the OTC item at the initiation of treatment which is to be kept on file at the pharmacy.

Before submitting an account

Before you submit an account, please ensure that:

your patient has either an accepted TAC claim (and has met the medical excess) or an accepted WorkSafe Claim

only one patient appears on each account

you do not issue the TAC or WorkSafe Agent with receipts or patient history reports.

Accounts should be in the form of a dispensary computer-generated tax invoice and must be addressed to the TAC or relevant WorkSafe Agent.  The status of an item, for example OTC, may be handwritten onto the tax invoice.

You can use our pharmacy invoice template XLS, 0.03MB  to help you in preparing your invoices. 

Your patient can also choose to pay for their pharmacy items themselves and then seek reimbursement from the TAC or WorkSafe agent.  The patient may therefore ask you for a dispensary computer- generated tax receipt to ensure all necessary information is provided to the TAC or WorkSafe agent.

Invoicing requirements 

Information to include on your account for dispensary medications The TAC and WorkSafe Agents require the following information in order to process your invoice:

 

Payee details Patient details  Medication details 
TAC payee number of WorkSafe provider number Family name and given name(s) Date dispensed 
Pharmacy name  Address For items billed under the Pharmaceutical Benefits Scheme (PBS), the PBS item code number  
Billing address  Claim number - if not known then patient's date of birth and date of accident or injury  A copy of the original script for private script medications 
Invoice number and date  

A copy of the repeat authorisation, where appropriate (for private medications only)

A full description of item (including script number, brand name and medication form)

Quantity of medication dispensed  

Total amount charged   

Medication strength (where applicable)

Amount charged per item

If the patient is a hospital patient, specify if medication prescribed is for outpatient or discharge

Fee Structure

The wholesale price is based on the Fred Dispense wholesale price. Sigma price 1 (wholesale cost excluding GST) or manufacturer's wholesale list price (excluding GST) will be used as the wholesale price for items not listed on the Fred Dispense System.

 

Privately prescribed items

All TAC clients and injured workers with a Medicare card are entitled to medications prescribed under the PBS. Both organisations can pay the reasonable costs of medications that are provided in accordance with the PBS. For prescribed items dispensed outside the PBS, the following fee structure will apply:

 

Wholesale price Mark up 1Dispensing fee 
Less than $100 Up to 60% $7.50 
Between $100 and $400 Up to 25% $7.50 
Greater than $400 Up to 10% $7.50 

Please note, Arrow pricing will be no longer be used.

1 Where there are multiple units of the product being supplied, the wholesale cost for mark-up purposes will be the total cost of quantity supplied

The dispensing fee for narcotic medications (Schedule 8) is $11.70. The TAC and WorkSafe Drugs of Dependence Policy states that funding for these medications outside the PBS will be considered in exceptional circumstances only.

Over the counter items

WorkSafe and the TAC can pay the reasonable costs of OTC items in accordance with the following:

 

NDPSC 1 classification Mark-up 2  3Dispensing fee 4 
No classification or Schedule 2 Up to 50% above the wholesale price None 
Schedule 3 (Pharmacist only) Up to 75% above the wholesale price No

1 National Drugs and Poisons Scheduling Committee (NDPSC), administered by the Therapeutic Goods Administration

2 Mark-ups are exclusive of GST, which may be added to the marked up price where applicable

3 Where there are multiple units of the product being supplied, the wholesale cost for mark-up purposes will be the total cost of quantity supplied

4 Dispensing fees are not paid for OTC items supplied by a pharmacist that are not on the PBS as this is not considered to be a reasonable cost

The TAC and WorkSafe do not consider a dispensing fee for an OTC item to be a reasonable cost, even when the TAC client or injured worker has a prescription. However, if an OTC item is prescribed on the PBS the pharmacist is entitled to dispense the item through the PBS and invoice the TAC or WorkSafe for the patient contribution.

Upon request from the TAC or WorkSafe pharmacists may be asked from time to time to produce documentation (request from medical practitioner or registered dentist) supporting the invoicing of OTC items for TAC clients or injured workers.

Reconciliation of accounts

Remittance advice, with detailed information about the status of each item you have invoiced, will be provided to you following the processing of your invoices. Please ensure that you reconcile your accounts each month using the remittance advice.

The TAC or WorkSafe Agent will not process or accept invoices that state 'outstanding balance'. If there is a difference between the billed amount and the amount paid by the TAC or WorkSafe Agent, please refer to the explanations on the remittance advice as indicated.

Where to get more information

If you have a query about a specific item for payment on your pharmacy invoice, please contact the TAC or relevant WorkSafe Agent. Information about the TAC and WorkSafe policies can be found at tac.vic.gov.au and worksafe.vic.gov.au or by contacting the TAC on freecall 1300 654 329 or WorkSafe Advisory Service on freecall 1800 136 089.

You may also wish to contact the Pharmacy Guild on (03) 9810 9999.