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    Yep, so a patient would visit a medical institution/pharmacy and pay the co-pay amount (30%). The medical institution/pharmacy would then submit a claim for the remaining portion (70%) to the insurer. This would be checked by Claims Review and Reimbursement Organizations (CRROs) and the amount paid out per the NHI Price List (also known as the NHI Drug Price Standard).

    Source 1, Health and Global Policy Institute:
    https://hotcopper.com.au/data/attachments/6360/6360840-2814a996d8b04991fdd437fc1b78a0ee.jpg

    Source 2, Pharmaceuticals and Medical Devices Agency:
    https://hotcopper.com.au/data/attachments/6360/6360843-e3c55c431fa46e83358b4c46b46ec009.jpg

 
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