Pharmacy Providers

Green Shield Canada
SSQ Insurance
MÉDIC Construction (Green Shield Canada)
Pharmacy Forms
Claim Reversal Request
Acquisition Cost Request Pharmacy providers only should use this form to request "cost-to-operator " adjustments in the event that reimbursement on a given claim was less than your actual acquisition cost for the item claimed.
Adjustment Pharmacy providers only should use this form to correct any incorrect or unknown information on the initially submitted claim (eg. to correct an incorrect DIN, correct a package size, quantity, or days supply,etc.).
Pharmacy Claim Submission Form Pharmacy providers may use this form to submit a manual claim in the event that the claim cannot be processed electronically. This form can be used for regular or compound claims.
Drug Authorization Forms A Drug Special Authorization form is required when a pharmacy receives a denial for an electronic drug claim that requires prior authorization.
Fill Limits Exception Request Form Request for coverage of additional dispensing fees associated with exceptions to the maintenance medication dispensing frequency policy (3 months supply) and/or use of compliance packaging.
Provider Banking Information Update form
Value-based Pharmacy

The goal of GSC’s Value-based Pharmacy initiative is to drive up the quality of care across Canada. By measuring pharmacy performance, providing feedback to facilitate improvement, and aligning reimbursement to the delivery of high-quality care, we help pharmacies gain insight into areas of patient care where they’re already doing well and areas where they can improve. For more information on quality-of-care measurement, our partners, and how the Pharmacy Quality Rating may impact pharmacy reimbursement, just select the links below.

Understanding Value-based Pharmacy
How Value-based Pharmacy Reimbursement Works
Frequently Asked Questions
Resources
Claims Payment Schedules

For your convenience, we have made our Claim Payment Schedules for each line of business available online. This will help you determine what claim details are included in each payment. To view these schedules, choose from the following:

Prior Year
Current Year
Update Newsletters

Green Shield Canada's Update newsletters give you the latest information on trends in the industry and Green Shield Canada news. Please choose from the list below (available in PDF format):

Pharmacy Update, National, 2022 08
Pharmacy Update, AB, 2022 06
Pharmacy Update, National, 2022 04
Pharmacy Update, National, 2022 01
Pharmacy Update, BC, 2021 11
Pharmacy Update, NB & NS, 2021 11
Pharmacy Update, National, 2021 11
Pharmacy Update, Atlantic, 2021 06
Pharmacy Update, National, 2021 06
Pharmacy Update, ARTA, 2021 04
Pharmacy Update, SK, 2021 04
Pharmacy Update, AB, 2021 03
Pharmacy Update, BC, 2021 03
Pharmacy Update, National, 2021 03
Pharmacy Update, National, 2021 01
Pharmacy Update, QC, 2021 01
Pharmacy Update, ARTA, 2020 12
Pharmacy Update, National, 2020 11
Pharmacy Update, QC, 2020 11
Pharmacy Update, National, 2020 06
Pharmacy Update, National, 2020 05
Pharmacy Update, National, 2020 03
Pharmacy Update, National, 2019 11
Pharmacy Update, ON, 2019 11
Pharmacy Update, AB, 2019 10
Pharmacy Update, BC, 2019 10
Pharmacy Update, National, 2019 10
Pharmacy Update, National, 2019 09
Pharmacy Update, BC, 2019 07
Pharmacy Update, MB, 2019 07
Pharmacy Update, National, 2019 07
Pharmacy Update, National, 2019 03
Pharmacy Update, ON, 2019 03
Pharmacy Update, QC, 2019 03
Pharmacy Update, National, 2018 12
Pharmacy Update, National, 2018 12
Pharmacy Update, ON, 2018 12
Pharmacy Update, QC, 2018 12
Pharmacy Update, National, 2018 10
Pharmacy Update, ON, 2018 10
Pharmacy Update, BC, 2018 09
Pharmacy Update, BC, 2018 08
Pharmacy Update, National, 2018 08
Pharmacy Update, Valsartan Recall, 2018 07
Pharmacy Update, National, 2018 04
Pharmacy Update, QC, 2018 04
Pharmacy Update, PE, 2018 01
Pharmacy Update, National, 2017 11
Pharmacy Update, ON, 2017 11
Pharmacy Update, MB, 2017 09
Pharmacy Update, National, 2017 08
Pharmacy Update, National, 2017 06
Pharmacy Update, ON, 2017 06
Pharmacy Update, National, 2017 04
Pharmacy Update, National, 2017 04
Pharmacy Update, ON, 2017 12
Pharmacy Update, SK, 2016 07
Pharmacy Update, MB & BC, 2016 07
Pharmacy Update, ON, 2016 07
Pharmacy Publications Archive

Pharmacy Manuals

Select a document below to view (in PDF) or print a copy:

Enhanced Generic Substitution
Frequently Used PINs for Billing Purposes
Intervention Codes
Maintenance Medication List
Maintenance Medication Policy Flowchart
Pharmacy Claims Manual
Topical Extemporaneous Compounds Policy

For more detailed inquiries about drug eligibility, criteria, other Green Shield Canada policies, etc., please contact our Customer Service Centre at 1-888-711-1119.

Pharmacy Forms
Claim Reversal Request
Acquisition Cost Request Form Pharmacy providers only should use this form to request "cost-to-operator " adjustments in the event that reimbursement on a given claim was less than your actual acquisition cost for the item claimed.
Pharmacy Adjustment Form Pharmacy providers only should use this form to correct any incorrect or unknown information on the initially submitted claim (eg. to correct an incorrect DIN, correct a package size, quantity, or days supply,etc.).
Pharmacy Claim Submission Form Pharmacy providers may use this form to submit a manual claim in the event that the claim cannot be processed electronically. This form can be used for regular or compound claims.
Provider Banking Information Update form
Claims Payment Schedules

For your convenience, we have made our Claim Payment Schedules for each line of business available online. This will help you determine what claim details are included in each payment. To view these schedules, choose from the following:

Prior Year Québec
Prior Year Outside Québec
Current Year Québec
Current Year Outside Québec
Update Newsletters

SSQ Insurance’s Update newsletters give you the latest information on trends in the industry and SSQ Insurance news. Please choose from the list below (available in PDF format):

Pharmacy Manuals

Select a document below to view (in PDF) or print a copy:

Frequently Used PINs for Billing Purposes
Pharmacy Claims Manual

For more detailed inquiries about drug eligibility, criteria, other SSQ Insurance policies, etc., please contact our Customer Service Centre at 1(800) 463-6262

Pharmacy Forms
Claims Payment Schedules

To view these schedules, please refer to the GSC tab.

Pharmacy Manuals

Select a document below to view (in PDF) or print a copy:

Frequently Used PINs for Billing Purposes

For more detailed inquiries about drug eligibility, criteria, other CCQ policies, etc., please contact our Customer Service Centre.



Requires Adobe Acrobat Reader
Get Adobe Reader