Information for device providers

 

This page links to the information most needed by device providers enrolled in PharmaCare.

On this page: Diabetes | Ostomy | Prosthetics and orthotics (P & O) application forms |  P & O invoices | P & O reimbursement schedules and PINS | PharmaNet access | Provider enrolment

Key resources: PharmaCare Policy Manual | Prosthetic and Orthotic Policy Manual

Diabetes

• Diabetes product PINs -- needles and syringes, blood glucose test strips, insulin pumps and supplies, flash and continuous glucose monitors, and approved vendors
• Blood glucose test strip and Special Authority criteria and forms
• PharmaCare Claims for Insulin Pump Vendors—Quick Reference Guide (PDF, 1.26MB)

Ostomy

The Ostomy PINs lists the ostomy supplies PINs eligible for coverage for patients who have undergone ostomy surgery and require an external pouch. Actual coverage is subject to the rules of the patient's PharmaCare plan, including any deductible requirements.

• Ostomy PINs
• HLTH 5413 - Ostomy Benefits Invoice (PDF, 609KB)

PharmaCare covers certain ostomy supplies for First Nations Health Authority clients under Plan W. The Non-Insured Health Benefits (NIHB) program may still cover some supplies not eligible under Plan W which may require NIHB prior authorization. 

Prosthetics and orthotics: application forms

• HLTH 5400 - Orthotic Benefits: Application for Financial Assistance (PDF, 671KB)
• HLTH 5450 - Orthotic Benefits: Plagiocephaly Helmet (PDF, 529KB)
• HLTH 5402 - Prosthetic Benefits: Application for Financial Assistance (PDF, 690KB)
• HLTH 5404 - Prosthetic Benefits (Non-Limb): Application for Financial Assistance (PDF, 683KB)
• HLTH 5418 - Offloading Orthotic Benefits Application for Financial Assistance (PDF, 2.2MB)
• HLTH 5467 - PharmaCare Eligibility: Awards and Settlements (PDF, 521KB)

Prosthetics and orthotics: invoices

• HLTH 5415 - Mastectomy Benefits Invoice (PDF, 500KB)
• HLTH 5417 - Prosthetic and Orthotic Benefits Invoice (PDF, 500KB)

Prosthetics and orthotics: reimbursement schedules and PINs

• Prosthetic and Orthotic PINs (device only), including mastectomy and ocular products and allowable repairs and adjustments
• Girling Formula for Prosthetic and Orthotic Devices (PDF, 151KB)
• PINs and Reimbursement Schedule for Mastectomy Supplies
• PINs and Reimbursement Schedule for Non-Limb Prostheses
• PINs and Reimbursement Schedule for Offloading Devices
• PINs and Reimbursement Schedule for Orthoses
• Reimbursement Schedule for Definitive Sockets
• Reimbursement Schedule for Osseointegration Components
• Reimbursement Schedule for Prosthetic and Orthotic Services and Supplies

PharmaNet access

• About PharmaNet
• Medical Device Distributors (MDD) Online Claims Access to PharmaNet allows authorized Medical Device Distributors to connect to PharmaNet to submit online claims for eligible products such as insulin pumps and insulin pump supplies. Medical Device Distributors must use approved secure software to connect to PharmaNet. They are not able to access a patient’s medication history. For information on requesting access to this service, visit the Data Access Services page.
• Medical Device Distributor Claims Access to PharmaNet—Policies & Procedures (PDF, 3.3MB)

Provider enrolment

The Provider Regulation ("the Regulation") under the Pharmaceutical Services Act ("the Act") came into force on December 1, 2014. The Regulation sets out new enrolment criteria for pharmacies, facilities, and other places where drugs, devices, substances or related services are provided ("sites"). It also sets out the commercial terms for the Province of British Columbia's relationship with enrolled providers.

More details at Provider Enrolment Guide