Insurance

Card Set Information

Author:
EmmaChey
ID:
153159
Filename:
Insurance
Updated:
2012-05-09 18:45:43
Tags:
Pharmacy Insurance
Folders:

Description:
Insurance Test
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The flashcards below were created by user EmmaChey on FreezingBlue Flashcards. What would you like to do?


  1. The term "third party" refers to?
    Insurance Company
  2. What are two formularies that can be categorized?
    • 1. Open V Closed
    • 2. Positive V Negative
  3. What is the purpose of a signature log?
    Record prescription has been delivered.
  4. What is another form of Physicians information?
    • NPI
    • (National Provider Identification)
  5. When NDC does not match what do you do?
    Double check the medication. Sometimes manufacturer and package size has changed.
  6. What is the role of the P&T committee w/ insurance?
    To develop formulary policies and educational programs.
  7. What is not transmitted to PBM?
    Pharmacists name.
  8. Procedure when PT is on vacation.
    Call PPM help line.
  9. Two main types of manages insurance.
    • 1. HMO
    • 2 PPO
  10. What is a prior authorization(to PT)?
    A process that requires your Dr to submit a from stating why you need the meds.
  11. When is a PA required?
    • 1. High cost injection meds
    • 2. Subject to abuse
    • 3. Early refills
    • 4. Vacation refills
    • 5. Early refills
  12. "Plan limits exceeded" error. What do you check?
    • 1. Quantity
    • 2. Day Supply
  13. Medicare type seen most at pharmacy.
    Medicare Part D.
  14. Calculate day supply for 200 puff inhaler. Sig: inhale 2 puffs po qid.
    25 days

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