Professional Documents
Culture Documents
Pharmacy Patient
Rx Prescriber Payer
Pharmacy Reimbursement
• Let’s concentrate on the transaction that most
pharmacists are familiar with:
• Community pharmacy dispensing a drug to a patient
who is covered by a third-party payer
• Every payer has a contract with a pharmacy to be a
provider in their network
• For example, if you are a member of Pitt Street Health
Plan and you wish to go to Joe’s Pharmacy to get your
drug; Pitt Street Health will have a contract set up with
Joe’s Pharmacy to pay them a certain amount for the
drug and the services they render to you as a member
Pharmacy Reimbursement (example, cont.)