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anthony7
7
| Question | Answer |
|---|---|
| Define generic name for a drug. | A term referring to the chemical makeup of a drug rather than to the advertised brand name under which the drug is sold. |
| What is the main difference between an HMO and a PPO? | The difference between HMO's and PPo's is that the patient usually pays more out-of-pocket expenses for PPO's. |
| Identify which government agency runs Medicaid and which one runs Medicare. | Medicare is run by the federal government and medicaid is run by each state. |
| Do all pharmacies have to accept all insurances? | No. |
| What does the term rotating stock mean? | When you put the medications that are about to expire in the front and put the newer medications in the back. |
| Are reconstituted cytotoxic agents returnable to the manufacturer? | No. |
| Define formulary. | The formulary is a list that describes all the medications covered under the insurance plans. |
| Why is it that most insurance companies will only cover generic name drugs? | Because they are cheaper. |
| Who is responsible for contacting the patient who may have received a recalled drug from the pharmacy? | The pharmacist. |
| Which type of drugs comes with paper work that must be completed and returned to the manufacturer each time that a medication is given? | Controlled substances, investigational drugs, and cytotoxic drugs. |
| Which party does third-party billing refer to? | The insurace company. |
| Identify the various types of HMO's discussed in this module. | Blue cross, united health care, pacific care, campus tricare program & kiaser. |
| Identify the features of HMO's. | They have a primary care physician, independent physician association, and copay. |
| Identify the insurance program that covers low-income residents. | Medicaid. |
| What is the process by which all claims are processed over a computer system called? | Adjudication. |
| Identify the common reasons that a prescription may not be covered. | Coverage has expired, coverage limits have been exceeded, NDC is not covered, patient is trying to refill a prescription to early, the card holder's information does not match the processors information, or the doctor is not the primary care physician. |
| What is the minimum amount of medication that should be maintained in the pharmacy? | The periodic automatic replenishment level. |
| Identify the possible reason for reterning drugs to the manufacturer. | Drug recalls, damaged stock, or expired stock. |
| Who is responsible for maintaining the inventory in the pharmacy? | Every one working in the pharmacy. |
| What is it called if the provider requires a predetermined amount to be paid for office visits? | Copay. |
| Identify the information that an insurance company needs when processing a prescription. | Patients name, date medication is filled, pharmacy name and address, medication prescribed, dosage, DOB, and ID number. |
| Which book should be used to determine the price of a medication based on the manufacturers price. | The red book. |
| Identify where the pharmacy technician would normally order medications? | Centralized warehouce that the pharmacy knows from a whole seller or directly from the manufacturer. |
| What is it called if the provider allows the patient to choose a main physician rather than having to be seen by the physician on duty? | PPO. |
Created by:
lakers24