VERSION REAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)|AGRADE||BRAND
NEW VERSION!! Guilford Technical Community
College
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