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PTCB Concise Review

Pharmacy PTCB Updates

QuestionAnswer
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
Created by: talennna