Information for people who provide pharmaceutical services to employees who have an accepted claim under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act).
Pharmacy services and medication
Pharmacists provide medicines that are reasonably required as a result of an employee’s workplace injury or illness.
Medicines include both prescription pharmaceuticals and non-prescription pharmaceuticals such as analgesics, supplements and topical creams.
Comcare supports the safe prescription and dispensation of medicines, especially high-risk medicines such as benzodiazepines and opiates.
Standards for service providers
Pharmacists must be registered with the Australian Health Practitioner Regulation Agency (AHPRA) in order to provide services to ill or injured employees within the Comcare scheme.
Please see Operating as a Comcare service provider for more information on standards for providers.
Process of engaging pharmaceutical services
Step 1: Employee applies
An employee who has an accepted claim for compensation under the legislation applies for pharmaceutical services, supported by information from their medical practitioner.
Step 2: Assessment
A claims manager in the Comcare scheme makes an assessment of whether the prescribed medications are reasonably required as a result of the employee’s injury or illness.
Step 3: Determination issued
If approved, the claims manager issues a determination for the relevant medications to the employee in writing. The determination shows the quantities and the length of time they have been approved for.
Step 4: Employee engages a provider
The employee selects their preferred pharmacist. You can ask the employee to view the determination letter, if you want to check the medications that the claims manager has approved. You can also ask the employee or their claims manager for the list of the approved medications.
Step 5: Services are reviewed
Claims managers regularly review the medicines which are approved to ensure the:
- employee is receiving medications in the appropriate quantities
- types of medications being provided continue to meet the employee’s needs.
Pharmacy policies for Comcare-managed claims
The following policies are for pharmacists providing services to employee’s with an accepted claim managed by Comcare. They provide information on medications Comcare can and cannot pay for and employees’ entitlements to access the Pharmaceutical Benefits Scheme (PBS).
Some licensees may also have their own policies relating to dispensing and paying for pharmaceuticals and you should contact them directly if you would like more information.
Pharmacy Policy (PBS prescribing and Schedule 8 medications) (PDF, 105.0 KB)
Pharmacy Pricing Policy (PDF, 100.2 KB).
Payment for services
How providers are paid
There are two ways you can be paid:
- through the claims manager (preferred method), or
- by the employee.
Through the claims manager
Ways to invoice Comcare
Healthcare providers can submit their workers’ compensation claim-related invoices to Comcare for payment in three ways:
- Digitally via Medipass - This is our preferred invoicing method, and the quickest way to get paid
- by email at email@example.com
- by post to Comcare, GPO Box 9905, Canberra ACT 2601
If you submit your invoices to Comcare digitally through Medipass, payment is usually next business day for approved invoices.
If you submit your invoices to Comcare by email or post, processing and payment will take longer. See more information on what to include on your invoice and if to apply Goods and Services Tax.
Remember, only submit invoices to Comcare after services have been provided.
For information on what you need to include in your billing account submission, see the Pharmacy Policy (PBS prescribing and Schedule 8 medications) (PDF, 105.0 KB).
For more information on invoicing and other billing requirements, see Invoicing and Payment.
If the employee’s claim is managed by a self-insured licensee, you should work directly with the licensee.
By the employee
Where necessary, pharmacists can seek payment directly from the employee receiving the service. The employee can then seek reimbursement from their claims manager.
For more information, see Reimbursement - Receipts.
For more information: