1. ACPC AGM 2012 April 21, 2012 Toronto, ON
ACPC/ Telus Solution
ACPC AGM 2012
April 21, 2012
Toronto, ON

2. Outline of the Problem Telus Letters to our Membership
Instructing pharmacies to accept Telus cards for compounded prescriptions or risk losing ability to bill Telus for any Rx
Pharmacies continue to get clawed back when they do bill Telus

3. History of Meetings ACPC/Telus
February initial meeting
April 2011 Telus attended our AGM
September shared frustrations
March proposed solutions/ mutual agreement

4. Proposed Solution COST- wholesaler costs of chemicals
TIME- $1.50 per minute; follow Telus guidelines
FEE- usual and customary fee
COMPOUNDING SUPPLEMENTAL FEE- see checklist

5. Compounding Supplemental Fee Checklist
Chemical Sourcing Fee
pH Adjustment
Formula Development
Special Equipment- EMP, Ointment Mill, Capsule Machine, tube sealer, Syringes
Nitrile gloves, FIT tested HEPA Mask for hormones
Powder Containment Hood or Sterile Facility
Sample Testing

6. EXAMPLE
Rx presented for BiEst 80:20 0.5mg/gm for 35 grams in Topiclik by customer with an Assure drug plan
We look up what it would cost for a cash customer. Example $ 65.00
Calculate what Telus Reimbursement Guidelines would allow us to bill

7. Example continued
Ingredient costs- estriol, estradiol, cosmetic HRT cream, Topiclik device= $ %= $13.40
Time- as per Telus guidelines= 16min x $1.50= $24
Fee- $11.99 (my usual and customary)
Difference between what Telus will pay ($49.39) and what I want a cash customer to pay ($65.00) will become my Compounding Supplemental Fee= $15.61

8. Example continued
Explain to customer what the Compounding Supplemental Fee will cost them and why we are charging it;
For example: Mrs. Smith, this Rx requires us to specially compound this hormone formulation in our hood, our staff has to use special equipment such as double nitrile gloves and hepa mask and then the final product is put into a user friendly applicator for you. This is the reason for the extra fee.

9. Example Continued
Have patient sign off on the Compounding Supplemental Fee- bill this separately
Call Telus to confirm they will pay for the compound; they will ask ingredients and quantities; get a ticket # and agent name for approval; they will confirm coverage but not price; do not bill them the supplemental fee
Have to call Telus on any new Rx for that client or change in drug plan

10. Next Steps for ACPC
Talk with members in provinces other than Ontario to see if this will work for them
Clarify procedure with Telus for ingredients not found in the wholesalers.
Help develop improved sterile compounding reimbursement guidelines
Continued meetings with Telus to keep lines of communication open