Practice Test for the PTCB Pharmacy Technician Certification Exam QUESTIONS WITH COMPLETE SOLUTIONS

A Health Maintenance Organization (HMO) requires a patient to use ____ and either recommends or requires the use of ____. correct answer: in-network pharmacies; generic drugs Patients in a Preferred Provider Organization (PPO) can use ____. correct answer: in-network or out-of-network pharmacies The 4 parts of Medicare are: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage Plan that is private insurance), and Part D (______________________). correct answer: prescription drug insurance What government entity runs Medicaid? correct answer: state governments When a patient presents an insurance card, the information is entered into the computer, and a claim is sent to the insurance company for payment or rejection. The process of the insurance company accepting or rejecting a claim is called ____. correct answer: adjudication The process in which a drug requires further review to determine if it is covered is called ____. correct answer: prior authorization The codes used to bill different medical conditions are called ____. correct answer: ICD codes Who is contracted by insurance companies to process the claims for the insurance company's members? correct answer: PBM or Pharmacy Benefits Manager What is a flexible spending account? correct answer: an account through a patient's employer where patients can use pre-tax dollars for medical expenses The term used to describe the services provided by a pharmacy to patients in an assisted living facility or a nursing home is called ____. correct answer: long-term care Patients with more than one third-party payer will utilize this process for the benefits of both plans to be used. correct answer: coordination of benefits / COB The block-rate payment collected from patients for their share of the prescription cost is called a ____. correct answer: copay Which of these is usually not found on a patient's prescription card? correct answer: date of birth