PTCB Pharmacy Billing and Reimbursement Practice Questions and Answers Latest

PTCB Pharmacy Billing and Reimbursement Practice Questions and Answers Latest . The cost of the coverage of an insurance policy is known as which of the following? A. Deductible B. Co-payment C. Coinsurance D. Premium 5. Which of the following is another name for the cardholder of the insurance policy? A. Subscriber B. Dependent Pharmacy Billing and Reimbursement PTCB Practice Test Questions and Answers Latest Rated A+ C. Patient D. Third party 6. When a patient picks up a prescription in the pharmacy, he or she may be responsible for an out-of-pocket expense known as which of the following? A. Co-payment B. Premium C. Deductible D. Third party 7. The part of Medicare that covers the costs of prescriptions for Medicare patients is known as which of the following? A. Part A-COVERS IN-PATIENT , HOSPITALIZATION, B. Part B—COVERS OUT-PATIENT,MEDICAL SUPPLIES, PREVENTATIVE SERVICES C. Part C-SUPPLEMENTAL INSURANCE-COMBINED D. Part D-COVERS PRESCRIPTION, DIABETES SUPPLIES 8. Which organization oversees Medicaid and Medicare? A. Food and Drug Administration (FDA) B. Drug Enforcement Agency (DEA) C. Centers for Medicare and Medicaid Services (CMS) D. United States Pharmacopeia (USP) 9. Which of the following is a formulary? A. A list of insurance companies that offer pharmacy benefits B. List of providers that are included in an HMO C. List of approved medications in a member’s plan D. Recipe for how to make specific medications 10. If a drug is not covered under a patient’s prescription plan, but the prescriber specifically wants the patient to have this medication, the insurance company may require which of the following? A. Formulary B. Prior authorization C. Adjudication- ELECTRONIC SUBMISSION OF CLAIMS D. Coordination of benefits11. Which code is used for the third party to determine if the proper brand or generic medication was used to fill the prescription? A. USAN B. DAW C. Adjudication D. Trade