PACE

PROVIDER BULLETIN

September 16, 2005

State Worker’s Insurance Fund

(SWIF)

Program

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:

1-800-835-4080

PPB-05-019