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vocab chap13,14
Vocabulary chapter 13 and 14
| Inventory | A list of goods or items a business uses in its normal operations. |
| Formulary | A list of medications approved for use. |
| Open Formulary | A system that allows a pharmacy to use any prescribed medication. |
| Closed Formulary | A limites list of approved medication. |
| Therapeutic Equivalent | Pharmaceutical equivalents that produce the same effects in patients. |
| Perpetual inventory | A system that maintains a continuous record of every item in inventory so that it always shows the current amount of stock on hand. |
| Turnover | The rate at which inventory is used, generally expressed in number of days. |
| Point of sale system (POS) | An inventory system in which the item is deducted from inventory as it sold or dispensed |
| Reorder points | Minimum and maximum stock levels which determine when a reorder is placed and for how much. |
| Automated Dispensing System | A system in which medications are dispensed,upon confirmation of an order communicated from a centralized computer system, at their point-of-used. |
| Material Safety Data Sheets (MSDS) | OSHA required notices on hazardous substances which provide hazard, handling, clean-up, and first aid information. |
| Purchase Order Number | The number assigned to each order for identification. |
| Unit-dose packaging | A package containing a single dose of a medication. |
| Pharmacy Benefit Managers | Companies that administer drug benefit programs. |
| Online adjudication | the resolution of prescription coverage through the communication of the pharmacy computer with the third party computer. |
| Co-insurance | An agreement for cost-sharing between the insurer and the insured. |
| co-pay | The portion of the price of medication that the patient is required to pay. |
| Maximun allowable cost (MAC) | The maximum price per tablet (or other dispensing unit)an insurer or PBM will pay for a given product. |
| U&C or UCR | The maximum amount of payment for a given prescription, determined by the insurer to be a usual and customary (and reasonable) price. |
| Dual co-pay | Co-pays that have two prices: one for generic and one for brand medications. |
| Deductible | A set amount that must be paid by the patient for each benefit period before the insurer will cover additional expenses. |
| Prescription drug benefit cards | Cards that contain third party billing information for prescription drug purchases. |
| Formulary | A list of medications covered by third party plans. |
| Tier | Catergories of medications that are covered by third party plans. |
| HMOs | A network of providers for which cost are covered inside but not outside of the network. |
| POSs | A network of providers where the patient's primary care physician must be a member and cost outside the network may be partially reimbursed. |
| PPOs | A network of providers where costs outside the network may be partially reimbursed and the patient's primary care physician need not be a member. |
| Medicare | A federal program providing health care to people with certain disabilities or who are over age 65; it includes basic hospital insurance, voluntary medical insurance, and voluntary prescription drug insurance. |
| Medicaid | A federal-state program, administeres by the states, providing health care for the needy. |
| Worker's compensation | An employer compensation program for employees accidentally injured on the job. |
| Patient assistance programs | Manufacturer sponsored prescrption drug programs for the needy. |
| Universal Claim Form (UCF) | Astandard claim for accepted by many insurers. |
| CMS-1500 (formerly HCFA 1500) form | The standard form used by health care providers, such as physicians, to bill for service. It can be used to bill for disease state management services. |
| Medication Therapy Management Services (MTMS) | Services provides to some medicare beneficiaries who are enrolled in Medicare Part D and who are taking multiple medications or have certain diseases. |
| Prescription Drug Plans (PDPs) | Third party programs for Medicare Part D. |
| National Provider Identifier (NPI) | The code assigned to recognized health care providers, needed to bill MTMS. |
| Current Procedural Terminology Codes (CPT Codes) | Identifiers used for billing pharmacist-provided MTM sercives. |
| CMSS-101114 Form | The standard form used by health care providers to apply for a NPI. |
Created by:
isacruz
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