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PTCB Concise Review
Pharmacy PTCB Updates
| Question | Answer |
|---|---|
| Medicare Part A (Hospital Insurance) | COVERS INPATIENT CARE AT A HOSPITAL, SKILLED NURSING FACILITY AND HOSPICE. PART A ALSO COVERS SERVICES LIKE LAB TESTS, SURGERY, DOCTORS VISITS, AND HOME HEALTH CARE. |
| MEDICARE PART B ( MEDICAL INSURANCE) | COVERS DOCTOR AND OTHER HEALTH CARE PROVIDERS SERVICES, OUPATIENT CARE, DURABLE MEDICAL EQUIPMENT (DME), HOME HEALTH CARE, AND SOME PREVENTATIVE SERVICES. |
| Medicare Part C (Prescription Drug Coverage) | ) MEDICARE PRESPCRIPTION DRUG COVERAGE EITHER THROUGH ADDING A MEDICARE PRESCRIPTION DRUG PLAN (PART D) OR GETTING A MEDICARE ADVANTAGE PLAN (PART C) SUCH AS AN HMO OR PPO THAT OFFERS MEDICARE PRESCRITPTION DRUG COVERAGE. |
| Medicare Part D | PRESCRIPTION DRUG COVERAGE WITH OTHER COVERAGE SUCH AS EMPLOYER OR UNION HEALTH COVERAGE |
| REVERSE DISTRIBUTOR | A REVERSE DISTRIBUTOR FOR PHARMACEUTICALS PICKS UP EXPIRED AND DAMAGED DRUGS FOR DISPOSAL AS PHARMACEUTICAL WASTE AND DOES NOT DISTRIBUTE NOR TRANSPORTS DRUGS. |
| BIN (BANK IDENTIFICATION NUMBER) | IDENTIFY WHICHCOMPANY REIMBURSES THE PHARMACY FOR THE MEDICATION.MOST PHARMACIES HAVE A LIST OF BINNUMBERS.A 6 DIGIT NUMBER WHICH TELLS THE PHARMACYWHERE THE CLAIMSHOULD BE SENT.THE PRIMARY ROUTING MECHANISM FOR A REAL-THIRD PARTY PRESCRIPTION Claim |
| POS | POINT OF SALE SYSTEM MADE UP OF A COMPUTER, MONITOR AND OF SOFTWARE FOR RETAIL PURPOSES AND IT HELPS THE PHARMACY DETERMINE THE PATIENT’S CO-PAYMENT. |
| BCMA | BAR CODE MEDICAL ADMINISTRATION IS A TYPE OF TECHNOLOGY THAT DOCUMENTS ADMINISTRATION OF MEDICATION USING ELECTRONIC SENSORS. BCMA SOFTWARE IS DESIGNED TO IMPROVE THE ACCURACY OF THE ADMIISTRATION PROCESS. |
| CMS | CENTERS FOR MEDICAID AND MEDICAL SERVICES |
| Needles | 1. “THE ONE HAND SCOOP” METHOD OF RECAPPING IS SAFER THAN USING TWO HANDS 2. MMUNIZATION NEEDLES ARE NEVER RECAPPED |
| SYRINGES: | 1CC/ML=100 units. A TUBERCULIN SYRINGE IS USED TO MEASURE ANYTHING LESS THAN 1ML OR LESS THAN 100 UNITS. |
| SPECIAL IV TUBING | S RECOMMENDED FOR THE ADMINISTRATION OF NITROGLYCERIN |
| TALL MAN LETTERING | IS USED WHEN WRITING PART OF A DRUG’S NAME IN UPPER CASE LETTERS TO HELP DISTINGUISH SOUND-ALIKE, LOOK-ALIKE DRUGS FROM ONE ANOTHER IN ORDER TO AVOID MEDICATION ERRORS. FOR EXAMPLE: prednisoLONE / predniSONE |
| LOOK ALIKE/SOUND ALIKE MEDICATIONS ALSO KNOWS AS SALADS: | MEDICATIONS THAT LOOK ALIKE AND SOUND ALIKE ARE ADDRESSED IN THE ACCREDITATION STANDARDS OF THE JOINT COMMISSION BECAUSE THESE PRODUCTS HAVE A HIGH ERROR RISK DUE TO PICKING ERRORS. FOR EXAMPLE: LOREZEPAM/CLONAZEPAN |
| ASHP GUIDELINES | STATE THAT A QUALITY IMPROVEMENT PROGRAM FOR HOME CARE SHOULD MONITOR PATIENTS PHYSICAL EXAMINATIONS AND LABORATORY VALUES. |
| iPLEDGE | A DRUG RESTRICTED PROGRAM DEDICATED TO PREVENT FETAL EXPOSURE DRUGS INCLUDED IN THIS LIST ARE:CLARAVIS- ACCUTANE, AMNESTEEN, SOTRET, ABSORICA, ZENATANE AND MYORISAN. |
| POTTASSIUM CHLORIDE INJECTION 10mEq/5ML 30 Ml | l WOULD BE CONSIDERED A HIGH ALERT MEDICATION FOR A PHARMACY TECHNICIAN ASSSIGNED TO STOCK REPLENISHMENT BECAUSE THIS IS A DRUG IN THE (ISMP) AND IT BEARS A HEIGHTENED RISK OF CAUSING SIGNIFICANT PATIENT HARM WHEN THEY ARE USED IN ERROR.. |
| ISMP (INSTITUTE FOR SAFE MEDICATION PRACTICES) w | www.ismp.org |
| NON –FORMULARY MEDICATION | THE REQUIREMENT THAT A NON-FORMULARY MEDICATION BE COVERED ONLY IF APPROVED BY THE THIRD PARTY PAYER IS CALLED: PRIOR AUTHORIZATION |
| WATER CONTAINING FORMULATIONS | IN THE ABSENCE OF STABILITY INFORMATION WATER CONTAINING FORMULATIONS (PREPARED FROM INGREDIENTS IN SOLID FORM) SHOULD BE ASSIGNED BY A BEYOND USE DATE THAT IS NO LATER THAN 14 DAYS WHEN STORED AT COLD TEMPERATURE. |
| OUTPATIENT PRESCRITPIONS | OUTPATIENT PRESCRIPTIONS REQUIRE PHYSICIANS PHONE NUMBER AND ADDRESS. |
| PHARMACY MANAGEMENT | PRODUCTIVITY REPORTS ARE PRIMARILY USED BY PHARMACY MANAGEMENT TO EVALUATE AND IMPROVE WORKFLOW |
| PRESCRIPTION BALANCES | CLASS “A” BALANCE HAS A SENSITIVITY REQUIREMENT OF 6mg. |
| THE RED BOOK | THE RED BOOK BRINGS THE LATES PRICING AND PRODUCT INFORMATION IT COVERS THE FULL SPECTRUM OF CURRENT DRUG PRICING POLICIES. |
| THE ORANGE BOOK | THE ORANGE BOOK COMPARES THERAPEUTICAL EQUIVALENCE SO THE LETTER “AB” RATING INDICATES THAT PRODUCTS ARE CONSIDERED BIOEQUIVALENT |
| FLOW HOODS | VERTICAL FLOWHOODS ARE USED TO PREPARE CYTOTOXIC DRUGS OR CHEMOTHERAPY MEDIATIONS. VERTICAL FLOWHOODS ARE ALSO CALLED BIOLOGICAL SAFETY CABINETS. |
| THIRD PARTY | THIS IS ANOTHER PARTY OR THE INSURANCE BESIDES THE PHARMACY THAT PAYS TO AN EXTENT THE COST OF MEDICINE. |
| THIRD PARTIES | THERE ARE MANY THIRD PARTIES WITH MANY PLANS TO MEET DIFFERENT NEEDS OF THEIR CUSTOMERS. ALL THIRD PARTIES HAVE ONE OF THREE DIFFERENT TYPES OF PAYMENTS: CO-PAYMENT, VARIABLE RATE AND A PERCENTAGE OF COST OF THE MEDICATION. |
| CO-PAYMENT | THIS TYPE OF PAYMENT CHARGES A FLAT RATE REGARDLESS OF THE COST OF THE MEDICATION. THERE IS USUALLY A SET PAYMENTFOR BRAND DRUGS OR NON- PREFERRED DRUGS (A DRUG THAT IS NOT ON THE FORMULARY) AS WELL AS GENERICS |
| MEDICAID | A STATE/FEDERAL PROGRAM OF ASSISTANCE FOR THE POOR |
| MEDICARE | A FEDERAL PROGRAM OF HEALTH INSURANCE FOR PEOPLE OVER 65 YEARS OF AGE |
| HEALTH MAINTENANCE ORGANIZATION (HMO): | A NETWORK OF HEALTH CARE PROVIDERS IN WHICH PATIENTS MUST STAY WITHIN THE NETWORK SO THAT EXPENSES CAN BE EASILY CONTROLLED. |
| PREFERRED PROVIDER ORGANIZATION(PPO) | A NETWORK OF HEALTCHARE PROVIDERS IN WHICH PATIENTS MAY USE SERVICES OUTSIDE THE NETWORK, HOWEVER, THE EXPENSES WILL BE LESS IF THEY CHOOSE TO STAY WITHN THE NETWORK. |
| PHARMACY BENEFITS MANAGER (PBM): | A COMPANY WHOSE BUSINESS IS TO PROVIDE DRUG BENEFIT PROGRAMS TO INSURANCE COMPANIES. THEY USE THEIR SIZE TO NEGOTIATE WITH DRUG MAKERS AND PHARMACIES. |
| THE PHYSICIANS DESK REFERENCE (PDR) | IS A PUBLICATION THAT PROVIDES A COMPLETE COMPILATION OS THE INFORMATION THAT IS FOUND ON PRESCRIPTION MEDICATION. THIS COMPLIATION IS UPDATED ANNUALLY AND CAN BE FOUND IN BOOKSTORES AND LIBRARIES. |
| THE MERCK INDEX: | AN ENCYCLOPEDIA OF CHEMICALS, DRUGS AND BIOLOGICALS WITH OVER 10,000 MONOGRAPHS ON SINGLE SUBSTANCES OR GROUPS OF RELATED COMPOUNDS. |
| THE UNITED STATES PHARMACOPEIA AND THE NATIONAL FORMULARY (USP-NF) | IS A BOOK OF PUBLIC PHARMACOPEIAL STANDARDS. IT CONTAINS STANDARDS FOR (CHEMICAL AND BIOLOGICAL DRUG SUBSTANCES, DOSAGE FORMS, AND COMPOUNDED PREPARATIONS) EXCIPIENTS, MEDICAL DEVICES AND DIETARY SUPPLEMENTS. |
| DRUG FACTS AND COMPARISONS | THIS BOOK PROVIDES UP-TO-DATE, COMPREHENSIVE INFORMATION ON OVER 22,000 Rx AND 6.000 OTC PRODUCTS GROUPED BY THERAPEUTIC CATEGORY FOR EASE OF COMPARISON. |
| CHOLESTYRAMINE POWDER | IS EXECPT FROM THE POISON PREVENTION PACKAGING. |
| COORDINATION OF BENEFITS | IS USED WHEN A PATIENT HAS PRIMARY AND SECONDARY INSURANCE. |
| DRUG ENFORCMENT AGENCY (DEA) | ACCORDING TO THE DEA ALL RECORD RELATED TO CONTROLLED SUBSTANCES MUST BE MAINTAINED AND BE AVAILABLE FOR INSPECTION FOR A MINIMUM OF 2 YEARS. |
| DEA 222 | IS USED FOR THE PURCHASING AND RETURNING OF OUTDATED CII DRUGS. |
| DEA 106 FORM | IS UDED TO REPORT LOST OR STOLEN CONTROLLED SUBTANCES. |
| DEA 41 | IS USED TO DOCUMENT THE DESTRUCTION OF CONTROLLED SUBSTANCES. |
| DEA 224 | IS NEEDED FOR FOR A PHARMACY TO DISPENSE CONTROLLED SUBSTANCES |
| DEA 363 | IS NEEDED TO OPERATE A CONTROLLED SUBSTANCE TREATMENT PROGRAM OR COMPOUND CONTROLLED SUBSTANCES |
| DEA225 | IS NEEDED TO MANUFACTURE OR DISTRIBUTE CONTROLLED SUBSTANCES |
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