Express Scripts Canada
Express Scripts Canada
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NIHB Pharmacy Provider Documentation

Registration

Instructions

To register in the Pharmacy NIHB Program:
1. Download the Pharmacy Provider Agreement:
pdf icon Pharmacy Provider Agreement

Sample Copy of a completed Pharmacy Provider Agreement:
pdf icon Pharmacy Provider Agreement (Completed Sample)
2. Complete the Pharmacy Provider Agreement fully for all required sections.
 Did you know…
 Electronic Funds Transfer (EFT) is free and secure?
  Sign up by completing the Payment Information section on the Pharmacy Provider Agreement and eliminate mail delivery delays of lost, misplaced, or stolen cheques! Receive your claim payments directly into your designated bank account on the day the payment is issued and still continue to receive mailed statements for reconciliation!
3. Sign the Pharmacy Provider Agreement (where indicated).
4. Fax all pages (including a photo copy of a VOID cheque or official bank letter for EFT payments) of the Pharmacy Provider Agreement to Express Scripts Canada at fax number 1-855-622-0669.

Quebec Pharmacies

The First Nations and Inuit Health (FNIH) Regional Office in Quebec maintains an umbrella agreement with the l’Association Québécoise des pharmaciens propriétaires (AQPP) on behalf of all pharmacies in Quebec, registered to provide services to NIHB clients.
The Pharmacy provider must contact AQPP to initiate the registration process, and the necessary documentation is then forwarded to Express Scripts Canada by fax to 1-855-622-0669.


Pharmacy Forms

Claims

pdf icon NIHB Pharmacy Claim Form


Claims Submission Kit

pdf icon NIHB Pharmacy Claims Submission Kit


Provider Information Changes

pdf icon Modification to Pharmacy and Medical Supplies and Equipment Provider Information Form


Contacts

Express Scripts Canada Provider Claims Processing Call Centre
Extended Hours of Operation: Monday to Friday
6:30 a.m. to 12 a.m. Eastern Time,

Saturday, Sunday and Statutory Holidays
8 a.m. to 12 a.m. Eastern Time
 
Telephone Inquiries: 1-888-511-4666
 
Mail:   For Pharmacy claims, mail to:
    Express Scripts Canada
NIHB Pharmacy Claims
P.O. Box 1353, Station K
Toronto, ON M4P 3J4
 
    For all other correspondence, mail to:
    Express Scripts Canada
5770 Hurontario St., 10th Floor
Mississauga, ON L5R 3G5
 
Health Canada
Click Health Canada Contacts to view all the NIHB Program contact numbers.

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www.express-scripts.ca
www.healthcanada.gc.ca/nihb