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2 methods of pharmacy claims submission to third party payer?

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Final answer:

Two methods of pharmacy claims submission to a third-party payer are electronic submission through a Point-of-Sale system, and manual submission via paper claim forms.

Step-by-step explanation:

One common method of pharmacy claims submission to a third-party payer is electronically through a Point-of-Sale (POS) system. The pharmacist or pharmacy technician enters the patient's insurance information and the details of the prescription drug into the system, which then transmits the claim to the insurance company or pharmacy benefit manager.

Another method involves submitting paper claims, which is less common nowadays. In this case, a pharmacist fills out a claim form with all necessary details about the prescription and patient's insurance, then mails it to the insurer or PBM. This process may be used when electronic submission is not possible, such as with certain types of insurance or for reimbursement.

It's important to note that programs like those introduced by the Medicare Prescription Drug and Modernization Act of 2003 have significantly impacted the way prescription drugs benefits are managed for groups such as the elderly and disabled.

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