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Terminology week 6

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Term
Definition
Adjudication   Electronic insurance billing for medication payment  
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Antifungal   Used to treat a fungal infection  
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Average wholesale price   Average price at which is drug is sold  
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Candida   Type of fungus  
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Closed formulary   List of medication that are the only ones reimbursement is allowed for under the patient's insurance plan  
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co-pay   Portion of the prescription bill that the patient is responsible for paying  
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Dermatophytes   Group of fungi responsible for most fungal infection of the skin, hair, and nails  
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Drug Topics Red Book   Reference book listing NDC numbers, manufacturers, and average wholesale pricing of drug products  
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Drug utilization review   Process by which pharmacists ensure proper medication utilization  
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Formulary   A list of preapproved medication that are covered under under a prescription plan and considered to be the most cost-effective  
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Fungus   Primitive plant that reproduces by budding, releasing, spores or fusing hyphae  
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Health Insurance Portability and Accountability Act   Federal guidelines for the protection of a patient's personal health information  
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Material safety data sheets   Information sheets supplied to the pharmacy from the manufacturer of chemical products  
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Medicare Modernization Act   Enactment of prescription drug coverage provided for persons covered under Medicare  
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Mycoses   General term for fungal infections  
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National Drug Code   Ten-digit number given to all drop identification purposes  
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National Provider Identifier   Number assigned to any health care provider that is used for the purpose of standardizing health data tranmissions  
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Onychomycosis   Fungal infection involving the fingernails or toenails  
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Open formulary   Formulary list that is unrestricted in the types of drug choices offered or that can be prescribed and reimbursed under the benefit plan  
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Patient profile   Document listing necessory patient persona and health information  
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Pharmacy and therapeutics committee   Medical staff who provide necessary information and advice to the institution  
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Point of sale   Where the sale or service takes place  
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Prior Authorization   Insurance-required approval for a restricted non-formulary medication  
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Ringworm   Group of tinea infections involving the body or scalp that have a characteristic ring-like shape  
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Trade, brand, or proprietary drug name   Name a company assigns for marketing and identification purposes to a commercial drug product  
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Treatment authorization request   Similar to preauthorization process used for medicare and medicaid  
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Medicaid   Government-managed insurance program providing care to individuals meeting specific requirements  
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Medicare   Government-managed insurance program providing care to individuals generally 65 or older  
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Medigap Plans   Supplemental insurance policies provided through private companies to cover costs not reimbursed by Medicare  
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Vulvovaginal candidiases   Yeast vaginitis  
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Workers's compensation   Government-required medical overage for workers injured on the job, paid by the employer  
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