Pharmacy Billing and Reimbursement

Nov 3rd, 2020

Welcome to your Pharmacy Billing and Reimbursement

1. In insurance, which of these terms refers to the main cardholder?
2. Members are NOT required to select a PHP under which of these insurance systems?
3. Prescription drug plans fall under which of these Medicare plans?
4. When medicines are dispensed, which of the following is paid by the patient to the pharmacy?
5. To maintain insurance coverage, what term is used to describe the cost of that patient’s insurance plan?
6. TRICARE is a government plan that covers which of the following patients?
7. Durable medical equipment (DME) – such as blood glucose monitors – are covered under which of the following Medicare plans?
8. What term is used to describe the amount that must be paid each year before the healthcare benefits of an insurance plan commence?
9. The biller identification number (BIN) is a _____________ number that is present on health insurance cards to specify an insurance plan from a defined carrier.
10. For prescription insurance plans, how frequently are deductibles reset?
11. Which Medicare plan covers defined vaccines administered to the patient at pharmacies?
12. Which of the following statements about Medicaid is true?
13. Patients with more than one kind of insurance coverage are obligated to follow which of these rules?
14. In which of these cases may an insurance company reject a patient claim?
15. The spouse of the insurance card holder is assigned which of these values?
16. Which of these terms refers to the act of processing an insurance claim?
17. Which of the following is covered by Medigap?
18. Prior authorization may be required in which of the following cases?
19. In which pharmacy book can you expect to find AWPs?
20. With whom are FSAs – flexible spending accounts – associated?
21. Nursing home stays are covered under which Medicare plan?
22. Which of these insurance code associations is false?
23. Which of the following statements about HIPAA is true?
24. Which of the following details is NOT required by insurance companies when processing a prescription claim?
25. Government provides or subsidizes which of the following kinds of insurance?
26. Which of these statements is false regarding Centers for Medicare and Medicaid Services (CMS)?
27. Under Medicare Part C, private insurance companies can offer which of these other Part benefits?
28. CHAMPVA is a government program that is involved in providing healthcare to which of these?
29. What is the coverage under Medicare Plan A?
30. Which of the following is required for members who are part of an HMO?