PHM 3250 PTCB EXAM | STUDY GUIDE,
PRACTICE QUESTIONS AND DETAILED
ANSWERS | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep
,NIH National Institute of Health
Employer Insurance Most employers provide health insurance to full time employees
Private Insurance Individuals can apply and pay for health insurance. Smaller businesses offer group rates
to their employees.
Copay The remaining amount an individual must pay for their medication after insurance. This
form of payment is collected at the point of sale (ie the pharmacy)
Medicare A Covers inpatient hospital stays
Medicare B Covers outpatient hospital stays and diabetic supplies, DME (durable medical
equipment), patients on long term disabilities, X-rays, dialysis, vaccines, and respiratory
nebulizers
Medicare C Additional coverage not covered under A or B. Often called the advantage plan or
choice plan.
Medicare Part D Covers prescription medications; usually processed by private insurance but funding is
provided by CMS (government)
Medicare Part E Supplemental coverage; covers A, B, and D (Different than just Medicare C)
Medicare C only covers A and B
HMO Health Maintenance organization
Health Maintenance Organization (HMO) With an HMO plan, you must select a primary care physician (PCP) from .a network of
local healthcare providers who will refer you to in-network specialists or hospitals when
necessary.
All of your care is coordinated through your PCP
Lost cost to the insurance and the patient
PPO preferred provider organization
,Perferred Provider Organization (PPO) Recommended list of in-network providers and hospitals
-If you choose a provider outside of your network, your copay may be higher
-More flexibility= pay more money per month
EPO Exclusive Provider Organization
Exclusive Provider Organization (EPO) Sort of like a combination between HMO's and PPO's
-There is a recommended list of providers and specialists but cannot pick a provider
outside of network
-You can pick any primary care physician but they must be in-network
Workers Compensation When a patient has been hurt at work and his/her company has agreed to pay for the
cost of his/her medication
out of pocket Individuals without health care coverage and have to pay out of pocket expenses
Pharmacy Benefit Managers PBM
-Primarily responsible for developing and maintaining the formulary, contracting with
pharmacies, negotiating discounts and rebates with drug manufacturers, and processing
and paying prescription drug claims.
-Working with self-insured companies and government programs; trying to reduce
pharmacy expenditures of the plan and trying to improve health outcomes
Drug Development Complex and time consuming; on average it takes 8-15 years for a drug to be developed
and approved by the Food and Drug Administration
3 Basic Steps of Drug Development 1. Research
2. Testing
3. Approval
Research Can be done be pharmacologists, toxicologists, clinical pharmacologists, pharmacists,
and physicians
-The objective of research is to find a new active ingredient or to modify the structure of
existing drugs
FDA Regulation The food and drug administration was established in 1906
-Charged with the regulation of medications ensuring their safety and effectiveness
before medications are brought to market
, Where does testing begin? In the laboratory
-Stability
-Structure
-Dosage forms of the drug
Tests are done in animals to assess _______ Toxicity
- A new drug must be deemed safe before used in humans
How many steps is the approval process for testing in humans 4
regulated by the FDA?
Human Test Phase 1 Objective: To assess the initial dose and to determine if humans can tolerate the drug
(toxicology)
-A new drug is tested on a few healthy individuals at the lowest dose and is slowly
increased
Pharmacokinetics absorption, distribution, metabolism, biotransformation, and excretion
Most drugs do not make it past phase _______ 2
Human Test Phase 2 When the drug passes the first phase
-The drug is tested on a few hundred volunteers who have the disease the drug is
intended for
-Extensive data on pharmacokinetic and toxicology profile of the drug are collected in
this phase
-The optimal dose of the drug is determined in this phase
Human Test Phase 3 -Must pass phase 2
- Drug is tested on thousands of patients in a health care setting
-Must be randomized, double blind (drug or placebo) controlled study
-Test the efficacy of the drug
PRACTICE QUESTIONS AND DETAILED
ANSWERS | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep
,NIH National Institute of Health
Employer Insurance Most employers provide health insurance to full time employees
Private Insurance Individuals can apply and pay for health insurance. Smaller businesses offer group rates
to their employees.
Copay The remaining amount an individual must pay for their medication after insurance. This
form of payment is collected at the point of sale (ie the pharmacy)
Medicare A Covers inpatient hospital stays
Medicare B Covers outpatient hospital stays and diabetic supplies, DME (durable medical
equipment), patients on long term disabilities, X-rays, dialysis, vaccines, and respiratory
nebulizers
Medicare C Additional coverage not covered under A or B. Often called the advantage plan or
choice plan.
Medicare Part D Covers prescription medications; usually processed by private insurance but funding is
provided by CMS (government)
Medicare Part E Supplemental coverage; covers A, B, and D (Different than just Medicare C)
Medicare C only covers A and B
HMO Health Maintenance organization
Health Maintenance Organization (HMO) With an HMO plan, you must select a primary care physician (PCP) from .a network of
local healthcare providers who will refer you to in-network specialists or hospitals when
necessary.
All of your care is coordinated through your PCP
Lost cost to the insurance and the patient
PPO preferred provider organization
,Perferred Provider Organization (PPO) Recommended list of in-network providers and hospitals
-If you choose a provider outside of your network, your copay may be higher
-More flexibility= pay more money per month
EPO Exclusive Provider Organization
Exclusive Provider Organization (EPO) Sort of like a combination between HMO's and PPO's
-There is a recommended list of providers and specialists but cannot pick a provider
outside of network
-You can pick any primary care physician but they must be in-network
Workers Compensation When a patient has been hurt at work and his/her company has agreed to pay for the
cost of his/her medication
out of pocket Individuals without health care coverage and have to pay out of pocket expenses
Pharmacy Benefit Managers PBM
-Primarily responsible for developing and maintaining the formulary, contracting with
pharmacies, negotiating discounts and rebates with drug manufacturers, and processing
and paying prescription drug claims.
-Working with self-insured companies and government programs; trying to reduce
pharmacy expenditures of the plan and trying to improve health outcomes
Drug Development Complex and time consuming; on average it takes 8-15 years for a drug to be developed
and approved by the Food and Drug Administration
3 Basic Steps of Drug Development 1. Research
2. Testing
3. Approval
Research Can be done be pharmacologists, toxicologists, clinical pharmacologists, pharmacists,
and physicians
-The objective of research is to find a new active ingredient or to modify the structure of
existing drugs
FDA Regulation The food and drug administration was established in 1906
-Charged with the regulation of medications ensuring their safety and effectiveness
before medications are brought to market
, Where does testing begin? In the laboratory
-Stability
-Structure
-Dosage forms of the drug
Tests are done in animals to assess _______ Toxicity
- A new drug must be deemed safe before used in humans
How many steps is the approval process for testing in humans 4
regulated by the FDA?
Human Test Phase 1 Objective: To assess the initial dose and to determine if humans can tolerate the drug
(toxicology)
-A new drug is tested on a few healthy individuals at the lowest dose and is slowly
increased
Pharmacokinetics absorption, distribution, metabolism, biotransformation, and excretion
Most drugs do not make it past phase _______ 2
Human Test Phase 2 When the drug passes the first phase
-The drug is tested on a few hundred volunteers who have the disease the drug is
intended for
-Extensive data on pharmacokinetic and toxicology profile of the drug are collected in
this phase
-The optimal dose of the drug is determined in this phase
Human Test Phase 3 -Must pass phase 2
- Drug is tested on thousands of patients in a health care setting
-Must be randomized, double blind (drug or placebo) controlled study
-Test the efficacy of the drug
