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Pharmacists

For: Service providers Information seekers

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:

  1. through the claims manager (preferred method), or
  2. by the employee.

Through the claims manager

If Comcare is managing the employee’s claim, you can submit your invoices:

Pharmacy accounts should be a dispensary computer-generated tax invoice addressed to Comcare. 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).

We usually make payment within 28 days of receiving the invoice. For more information on invoicing and other billing requirements, see Operating as a Comcare service provider .

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.

Page last reviewed: 10 March 2021
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Comcare
GPO Box 9905, Canberra, ACT 2601
1300 366 979 | www.comcare.gov.au

Date printed 16 Apr 2021

https://www.comcare.gov.au/service-providers/medical-allied-health/pharmacists