September 16, 2005
State Worker’s Insurance Fund
All PACE Providers have been mailed packets of information inviting their participation as an on-line pharmacy provider in the state’s worker’s compensation program.
Providers enrolling in the on-line system benefit by:
· eliminating paper claim submission
· knowing immediately if the prescription is covered
· receiving payment via EFT for a covered claim within 21 days.
Reimbursement formula is:
· the lesser of usual and customary charge or
· AWP minus 10% plus a $4.00 dispensing fee or
· Federal Upper Limits (FUL) plus a $4.00 dispensing fee.
►SWIF claims do not have a co-pay.
►SWIF is always the primary payer for worker’s compensation claims.
Please watch for the packet marked “SWIF ENROLLMENT” for more information about participating as a SWIF provider.
Questions concerning participation in SWIF may be directed to Provider Services at: