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Form Focus: Ohio Request for Injured Worker Outpatient Medication Reimbursement (C-17)

19 Dec, 2023 Frank Ferreri

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Columbus, OH (WorkersCompensation.com) -- In Ohio, form C-17, the Request for Injured Worker Outpatient Medication Reimbursement is used for medication reimbursement, including over-the-counter medications.

The following breaks down the requirements that accompany the form.

Prescription Requirement. The medication must be written as a prescription and dispensed by an enrolled pharmacy. Medications purchased at a physician’s office for at-home use are non-reimbursable.

Medical Supplies. A C-17 is not used for medical supplies, durable medical equipment, and other non-drug reimbursement items. These items should be billed directly to the managed care organization.

C-17 Instructions.
> A separate C-17 is required for each pharmacy.
> All sections, including worker and pharmacist signature, must be completed.
> Prescription labels or a pharmacy printout with pricing information must be sent. While photocopies are acceptable, a pharmacy cash register receipt is not acceptable.
>Change Healthcare must receive the C-17 within one year from the date of service.
> The C-17 and prescription labels with pricing information must be mailed to:

Change Healthcare
P.O. Box 769
Augusta, ME 04332

Reimbursement. Waiting to mail the C-17 until after the Bureau of Workers' Compensation has approved the claim will help prevent delays in reimbursement.

The reimbursement process goes as follows:
> Within three weeks of receiving a completed C-17, Change Healthcare will mail a check for reimbursement.
>Within 7 days of receiving a C-17 that could not be process, Change Healthcare will mail a letter explaining why reimbursement could not be processed.
> Reimbursement will be considered for prescriptions that meet the requirements of BWC's outpatient medication formulary and payment rules.
> Brand-name medications are reimbursed at the generic drug price when a generic medication was available.

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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law. Frank encourages everyone to consider helping out the Kind Souls Foundation and Kids' Chance of America.

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