PharmSeer Module 9 Questions and Answers | Exam Practice Questions

PharmSeer,./Module,./9,./Questions


who,./is,./the,./third,./party,./in,./a,./prescription,./program,./-,./correct,./answer,./✔
✔ insurer


what,./third,./party,./plan,./has,./the,./least,./control,./over,./consumer,./costs,./-
,./correct,./answer,./✔ ✔ traditional,./indemnity,./plans


If,./a,./third,./party,./provider,./wants,./to,./have,./maximum,./control,./over,./costs,,./w
hat,./plans,./should,./they,./offer,./-,./correct,./answer,./✔ ✔ an,./HMO,./plan


What,./best,./explains,./the,./role,./of,./a,./pharmacy,./benefits,./management,./syste
m?,./-,./correct,./answer,./✔ ✔
Enrolls,./pharmacies,./using,./contract,./specifying,./services,./that,./will,./be,./pr
ovided,./in,./exchange,./for,./a,./reimbursement


What,./are,./some,./examples,./of,./government,./administered,./third,./party,./paye
rs?,./-,./correct,./answer,./✔ ✔ TRICARE,,./medicaid,,./medicare


What,./insurance,./plan,./requires,./patients,./to,./choose,./in-
network,./prescribers,./-,./correct,./answer,./✔ ✔ managed,./care,./plan

,A,./patient,./asks,./a,./pharmacy,./technician,./general,./questions,./about,./prescript
ion,./coverage,./under,./medicare.,./What,./information,./should,./the,./technician,./
provide,./to,./the,./patient,./-,./correct,./answer,./✔ ✔
Medicare,./part,./D,./provides,./coverage,./for,./a,./reduced,./premium,./and,./some
,./cost-sharing,./for,./each,./prescription,./and,./refill




A,./pharmacy,./technician,./is,./entering,./a,./prescription,./for,./a,./new,./patient,./into
,./the,./pharmacy,./management,./system,./and,./triggers,./and,./out-of-


network,./alert.,./What,./describes,./this,./type,./of,./alert?,./-,./correct,./answer,./✔
✔
The,./patient,./will,./be,./required,./to,./pay,./a,./higher,./price,./for,./their,./prescripti
on,./as,./it,./is,./not,./in,./the,./managed,./care,./plan's,./network


A,./patient,./is,./uncertain,./about,./what,./type,./of,./pharmacy,./benefit,./program,./th
ey,./are,./enrolled,./in,./but,./thinks,./it,./is,./a,./traditional,./indemnity,./plan.,./What,./q
uestion,./should,./the,./pharmacy,./technician,./ask,./to,./clarify,./what,./type,./of,./pla
n,./the,./patient,./has?,./-,./correct,./answer,./✔ ✔
Do,./you,./submit,./your,./own,./claims,./to,./the,./insurance,./company,./for,./reimb
ursement?


What,./insurance,./plan,./allows,./a,./patient,./to,./see,./any,./prescriber,./but,./places,./
controls,./such,./as,./preauthorizations,./and,./expensive,./procedures?,./-
,./correct,./answer,./✔ ✔ managed,./indemnity,./plan

, A,./pharmacy,./technician,./should,./identify,./that,./what,./resource,./can,./provide,./
insurance,./plans,./for,./a,./patient,./who,./is,./searching,./for,./private,./health,./insura
nce?,./-,./correct,./answer,./✔ ✔ Affordable,./Care,./Act's,./Website


A,./patient,./asks,./a,./pharmacy,./technician,./to,./explain,./coverage,./gap.,./What,./s
hould,./the,./pharmacy,./technician,./say?,./-,./correct,./answer,./✔ ✔
"Once,./you,./have,./met,./the,./maximum,./charges,./for,./the,./year,,./the,./coverag
e,./stops,./for,./a,./short,./period,,./or,./gap"


What,./term,./describes,./an,./entity,./or,./organization,./that,./pays,./for,./a,./patient's,./
prescription?,./-,./correct,./answer,./✔ ✔ third,./party,./payer


A,./26,./year,./old,./patient,./who,./has,./been,./injured,./on,./the,./job,./comes,./to,./fill,./a,./
prescription,./for,./back,./pain,./medication.,./What,./type,./of,./insurance,./should,./t
he,./pharmacy,./technician,./enter,./into,./the,./pharmacy,./management,./system?,./
-,./correct,./answer,./✔ ✔ worker's,./compensation


A,./pharmacy,./technician,./is,./entering,./a,./prescription,./for,./a,./new,./patient,./into
,./the,./pharmacy,./management,./system,./and,./triggers,./and,./alert,./that,./the,./phar


macy,./is,./out-of-
network.,./What,./statement,./should,./the,./technician,./make,./if,./the,./patient,./insi
sts,./on,./filling,./the,./prescription,./at,./this,./pharmacy?,./-,./correct,./answer,./✔
✔
"our,./pharmacy,./is,./out,./of,./network.,./However,,./we,./can,./still,./fill,./your,./pre
scription,./if,./you,./pay,./out,./of,./pocket"