Pharmacist professional services and claims
Pharmacist professional services overview
California law recognizes pharmacists as healthcare providers and requires payment for eligible professional services performed by a pharmacist.
Blue Shield developed a reference guide to further describe payment for these services.
General guidance documents for pharmacists
Download a quick reference guide (PDF 1.7 MB) , which includes frequently asked questions and other helpful resources. .
Claims resources on Provider Connection
- Submitting claims
- Enrolling in EDI
- Electronic Claims Submission via Electronic Data Interchange (EDI)
- Contact Us
External website resources
- California Pharmacists Association (CPhA)
- California Right Meds Collaborative (CRMC)
- Board of Pharmacy (BOP)
BOP (resources, e.g., clinical practice protocols, sample collaborative practice agreements, etc.) - Department of Health Care Services
California Department of Health Care Services (DHCS) Pharmacy Manual
Search professional fee schedule
Search the claims professional fee schedule for Blue Shield allowances.
How to submit claims
Learn about submitting claims to Blue Shield electronically using EDI or by mail.
Payment policies and rules
Read an overview of payment processing policies and rules.
Claim issues and disputes
Submit provider disputes, check status, and view letters online.