Insurance Test

Which of the following is not a type of copayment?

Deductible

If you are filling a prescription for a child covered on their mother's prescription insurance, which relationship holder code would you use when submitting the claim to the insurance for reimbursement

03

Which piece of hospital pharmacy automation consists of drawers that hold preset levels of medications?

pyxis

Which of the following statements describes the characteristics of sanitizing agents?

They reduce the number of bacteria, fungi, and viruses on inanimate surfaces

Which of the following is not a characteristic of universal precautions?

human blood is the only body fluid that may carry contagious diseases

Which of the following is a computerized system that allows physicians to order medications or labs and also allows physicians to communicate with the pharmacy and other clinical areas

Computerized physician order entry

Which piece of community pharmacy automation uses bar codes to read prescription labels to pull and dispense the appropriate drug from its cassettes?

Baker Cell

Which of the following situations would not require prior authorization?

Partial fill of a C-ll drug

For a pharmacy to use its computer system for prescription adjudication, what must it have to route the prescription to the proper insurance company for processing?

Bank identification number

Which of the following is a computerized drug cabinet that aids in control of drugs stored in nursing stations, emergency departments, and surgical sites?

automated dispensing system

Which of the following statements regarding computerized physician order entry (СРОЕ) is inaccurate?

physicians use CPOE to bill for services

It a drug costs $9.99, and it retails for $17.99, what is its markup rate?

80%

If a drug costs $34.50, the pharmacy's overhead cost is $4.75, and the pharmacy wants to make a profit of $12.50, what should be the drug's selling price

$51.75

Automated dispensing systems in hospitals are used for which of the following purposes?

to store medications and to control electronic dispensing of medications

An insurance company uses which of the following pieces of information to verify insurance coverage?

Patient's name

Which of the following automatic dispensing is utilized in a hospital pharmacy?

OmniRx

Which of the following situations does not require a prior authorization?

Influenza vaccine past flu season

Pharmacies use computerized dispensing systems that count and dispense medications accurately, which helps to reduce errors. Which of the following automatic dispensers in a community setting does not call for a log to be maintained?

Kirby Lester

Which piece of community pharmacy automation is fully automated because it receives prescription dispensing information from the pharmacy software system, picks the appropriate drug, counts the appropriate number of pills, packages the pills, and labels the vials?

ScriptPro

For patients with Medicare insurance coverage, which part will pay for prescription drugs?

D

When a patient is required to pay a portion of their prescription drug cost, it is known as which of the following?

Co-payment

What is the purpose of coordination of benefits (COB)?

to ensure the maximum benefits are being paid to patients when they are covered under more than one insurance plan

If a patient has to pay $250 out of pocket (OOP) before their prescription coverage starts, what is the patient paying?

the deductible

The average wholesale price (AWP) is the average price from their wholesaler that pharmacies may purchase a drug for. The AWP for drugs can be found in which of the following?

Red Book

A technician is inputting insurance information for a new patient who is a child. The patient's guardian has given the technician their own insurance card and tells them that it is the same processing information and that it should "go through". What processing information needs to change in order for the medication to be processed through insurance?

Person code

Who is responsible for obtaining prior authorization for a specific medication?

physician

When a pharmacy requests payment from an insurance company for a prescription it dispensed to a patient

Insurance claim

Submitting a prescription for payment to a secondary insurance if the patient has one

Third-party adjudication

The insurance company that must be billed first

Primary coverage

What an insurance company charges an individual to maintain their insurance coverage

Insurance Premium

Obtaining approval for a drug from the patient's insurance before dispensing the drug

Prior authorization

The selling price minus the purchase price equals which of the following?

markup

If you are filling a prescription for someone covered under their spouse's prescription drug plan, which relationship holder code would you use when submitting the claim to the insurance for reimbursement?

02

Practicing universal precautions is essential in the pharmacy to achieve quality assurance during the dispensing process. Which of the following health conditions would not interfere with a pharmacy technician's ability to prepare compounded sterile products?

hypertention

When a pharmacy requests payout from a secondary insurance company for a prescription it dispensed to a patient, it is known as which of the following?

Third-party adjudication