Pharmacy Drug Claims. 1.6.1 Pharmacy drug claims shall be processed in accordance with the guidelines in Chapter 8, Section 9.1; however, there will be no discount applied to pharmacy drugs. The DVA/VHA medical facility will bill for outpatient prescriptions and prescription refills written for each 30 day supply (or fraction thereof) at the DVA/VHA medical facility’s costs for the prescription items plus a reasonable fee to cover the DVA/VHA medical facility’s dispensing costs. The DVA/VHA medical facility shall be reimbursed based on: 1.6.2 In addition, the DVA/VHA medical facility will collect copayments consistent with TRICARE requirements. The amount of copayment shall be deducted from the lower of the billed charge or the TRICARE allowable charge.
Appears in 4 contracts
Samples: Network Participation Agreement, Network Participation Agreement, Network Participation Agreement
