Learn Pharmacy Billing In Ontario

Master Ontario Pharmacy Billing: ODB, OHIP, NIHB & Private Insurance Claims, Coordination of benefits, Preventing audits

What you'll learn

Understand Ontario’s Pharmacy Billing System Learn how to navigate ODB, OHIP, NIHB, IFH, and private insurance plans. Gain in-depth knowledge of pharmacy

Process Claims Accurately & Efficiently Master early refill overrides, coordination of benefits, and special authorization requests. Reduce billing errors an

Optimize Pharmacy Revenue & Prevent Audits Learn best practices to ensure compliance and avoid financial penalties. Understand pharmacy audit processes and st

Handle Complex Billing Scenarios with Confidence Gain practical experience with real-world case studies and billing challenges. Learn how to troubleshoot reje

Requirements

General Understanding of Pharmacy Practice Ideal for pharmacists, pharmacy assistants, and technicians, but no prior billing experience is required.

Description

Ontario Pharmacy Billing Program: Master ODB, OHIP, NIHB & Private Insurance ClaimsUnlock the Secrets of Ontario Pharmacy Billing & Maximize ReimbursementAre you a pharmacist, pharmacy technician, or assistant looking to master Ontario’s pharmacy billing system? Do you want to avoid costly claim rejections, prevent audits, and optimize pharmacy revenue? This course is designed to give you practical, job-ready knowledge that you can apply immediately in a pharmacy setting.What You’ll Learn:-Understand Ontario’s Pharmacy Billing System – Learn how ODB, OHIP, NIHB, IFH, and private insurance plans work.-Process Claims Accurately & Efficiently – Master billing codes, coordination of benefits, and early refill overrides.-Prevent Billing Errors & Audits – Reduce claim rejections, avoid compliance issues, and protect your pharmacy from financial penalties.-Handle Real-World Billing Scenarios – Gain confidence in troubleshooting rejected claims and resolving insurance disputes.Who is This Course For?-Pharmacists & Relief Pharmacists – Want to optimize billing processes and reduce errors.-Pharmacy Technicians & Assistants – Responsible for processing insurance claims and improving accuracy.-Pharmacy Students & New Graduates – Looking to stand out in job applications and become job-ready.-Internationally Trained Pharmacists (ITPs) – Need to understand billing to work in Ontario pharmacies.-Pharmacy Owners & Managers – Want to train their team and maximize reimbursement.Course Features:-Step-by-Step Video Lessons – Easy-to-follow explanations of billing concepts.-Practical Case Studies – Learn from real-world pharmacy billing scenarios.-Audit Prevention Strategies – Avoid costly mistakes that could impact your pharmacy.-Billing Tips & Best Practices – Save time and increase efficiency in your daily workflow.Whether you are a beginner or looking to refine your knowledge, this course will equip you with the skills needed to excel in Ontario’s pharmacy billing system.Enroll today and take control of your pharmacy billing process!

Overview

Section 1: Module 1: Introduction to Pharmacy Insurance & Drug Plans

Lecture 1 Introduction

Lecture 2 What Is ODB & Who Qualifies?

Lecture 3 What is OHIP Plus?

Lecture 4 Understanding Deductibles & Co-Pays

Lecture 5 ODB Formulary & How to Check Drug Coverage

Lecture 6 Limited Use (LU) Codes

Lecture 7 Exceptional Authorization Program

Lecture 8 Test Strip Coverage Rules

Lecture 9 Intervention Codes: What They Are & When to Use Them

Lecture 10 Vacation Supply Requests – How to Handle Travel Medication Billing

Lecture 11 Trillium Drug Program (TDP)

Lecture 12 How to Rebill Insurance After 7 Days

Section 2: Module 2: Handling Special Billing Situations in ODB

Lecture 13 Lesson 1: Early Refills – When Can They Be Processed?

Lecture 14 Lesson 2: MD "No Sub" Prescriptions – What to Do?

Lecture 15 Lesson 3: What If There’s No Generic & The Patient Chooses Brand?

Lecture 16 Lesson 4: Adverse reactions to generic drugs

Lecture 17 Lesson 5: Methadone PCFA billing

Lecture 18 Lesson 6: Nutrition forms

Lecture 19 Lesson 7:Blister Packs & Frequent Dispensing Forms – Billing rules for complianc

Lecture 20 Lesson 8: Flu & Covid Vaccines billing

Lecture 21 Lesson 9: Expensive medications billing

Lecture 22 Extra Lesson: Naloxone Kits

Section 3: Module 3: Billing for Special Patient Categories

Lecture 23 Lesson 1: The NIHB (Non-Insured Health Benefits) Program – Billing for Indigenou

Lecture 24 Lesson 2: The IFH (Interim Federal Health Program) – Coverage for refugees & bil

Lecture 25 Lesson 3: Student Health Insurance Plans – What’s Covered & How to Bill

Lecture 26 Lesson 4: Smart Cards & Government Drug Benefit Programs

Section 4: Module 4:Private Insurance Claim Management

Lecture 27 Lesson 1: Private vs. Public Insurance – What’s the Difference?

Lecture 28 Lesson 2: How to Read Private Insurance cards

Lecture 29 Lesson 3: Coordination of Benefits (COB) – Billing Two Insurances for a Child

Lecture 30 Lesson 4: Understanding Maximum Coverage Limits & Co-Pay Adjustments

Lecture 31 Lesson 5: Test Strips & Lancets Pseudo-DINs – How to Bill Them

Section 5: Module 5: Pharmacy Audits & How to Stay Compliant

Lecture 32 Lesson 1: What Is a Pharmacy Audit & Why Do They Happen?

Lecture 33 Lesson 2: How to Prevent Billing Audit & Chargebacks

Lecture 34 Lesson 3: Audit Triggers – No Sub, DB Code, Early Refills & Other Red Flags

Lecture 35 Lesson 4: Case Study: Pharmacy Audit & How It Was Handled

Section 6: Congratulations

Lecture 36 Last words

Pharmacy Students & New Graduates, Internationally Trained Pharmacists (ITPs), Community Pharmacists & Relief Pharmacists, Pharmacy Technicians & Assistants, Pharmacy Owners & Managers