Question 1

The name a company assigns to a commercial drug product for marketing and identification purposes is called the _____________ name.

Accepted Answer

A)   trade
B)   brand
C)   proprietary
D)   all of the aboveE) B) and D)
F) None of the above

Question 2

Which of the following medications may require a prior authorization before adjudicating the prescription claim?

Accepted Answer

A)   Amoxicillin/clavulanate
B)   Botox
C)   Conjugated estrogens
D)   FurosemideE) All of the above
F) A) and C)

Question 3

Both Medicare and Medicaid were implemented in:

Accepted Answer

A)   1965
B)   1975
C)   1985
D)   1995E) B) and C)
F) C) and D)

Question 4

Which of the following is not a true statement about PPOs?

Accepted Answer

A)   The copay is usually lower for an office visit than with an HMO.
B)   PPOs may have an annual deductible.
C)   PPOs do not require a PCP.
D)   The patient may have to pay full price for the prescription and then send in the receipt for later reimbursement.E) C) and D)
F) A) and D)

Question 5

The processing of claims by insurance companies over a computerized system is called:

Accepted Answer

A)   Adjudication
B)   Adjustment
C)   Computerization
D)   Instant processingE) A) and B)
F) C) and D) A

Question 6

When a workers' compensation claim prescription is presented to the pharmacy, the technician should:

Accepted Answer

A)   Fill it, and obtain permission from the government agency at a later time
B)   Obtain information from the patient's human resource department before filling
C)   Fill it, and collect full payment from the patient
D)   Wait until receiving payment from the insurance company before fillingE) B) and D)
F) None of the above

Question 7

An innovator product is a:

Accepted Answer

A)   New generic drug
B)   New medication shape
C)   Drug product that was first patented and marketed by the owner or manufacturer
D)   Brand name drug that is produced by a non-proprietary companyE) B) and C)
F) All of the above

Question 8

Which part of Medicare helps pay for physicians' services and outpatient care?

Accepted Answer

A)   Medicare Part A
B)   Medicare Part B
C)   Medicare Part C
D)   Medicare Part DE) C) and D)
F) A) and D)

Question 9

The amount to be charged to the insured patient for a prescription is decided by the ______________.

Accepted Answer

A)   Pharmacy
B)   Patient
C)   Insurance company
D)   None of the aboveE) B) and C)
F) B) and D)

Question 10

Medicare Part D specifically covers:

Accepted Answer

A)   Prescription medications
B)   Surgery
C)   Physicians' visits
D)   Physical therapyE) A) and D)
F) A) and B)

Question 11

Which one of the following illnesses is the patient not exempt from insurance company limitations?

Accepted Answer

A)   Diabetes
B)   Acquired immunodeficiency syndrome (AIDS) 
C)   Human immunodeficiency virus (HIV) 
D)   CancerE) C) and D)
F) A) and C)

Question 12

What term refers to the portion of the prescription bill that the patient is responsible for paying?

Accepted Answer

A)   Coinsurance
B)   Copayment
C)   Deductible
D)   PremiumE) B) and D)
F) C) and D)

Question 13

The information needed by insurance companies to process a claim from the pharmacy or to reimburse the patient is the same as the information required on a pharmacy label, plus:

Accepted Answer

A)   Patient's date of birth
B)   Insurance group number
C)   Insurance identification number
D)   All of the aboveE) A) and C)
F) All of the above

Question 14

A system that automatically tracks inventory is:

Accepted Answer

A)   Ordering cards
B)   Automatic dispensing systems (ADS) 
C)   Handheld inventory computers
D)   Bar codingE) C) and D)
F) A) and B)

Question 15

Prescription coupon cards are issued by:

Accepted Answer

A)   Drug manufacturers
B)   Medicare
C)   PBMs
D)   All of the aboveE) C) and D)
F) A) and D)

Question 16

Which of the following types of patients would not be eligible for Medicare coverage?

Accepted Answer

A)   Disabled patients
B)   Senior citizens
C)   Dialysis patients
D)   Healthy babiesE) None of the above
F) A) and B) D

Question 17

Point-of-sale (POS)  billing allows the insurance company to:

Accepted Answer

A)   Price a claim
B)   Verify eligibility
C)   Identify covered drugs
D)   All of the aboveE) All of the above
F) C) and D)

Question 18

Mail-order companies usually fill up to a __________ supply for certain maintenance drugs.

Accepted Answer

A)   90-day
B)   120-day
C)   150-day
D)   180-dayE) B) and D)
F) B) and C)

Question 19

PPO means :

Accepted Answer

A)   Preferred provider option
B)   Preferred provider organization
C)   Preferred physician option
D)   Preferred physician organizationE) B) and C)
F) A) and D) B

Question 20

The term third-party billing refers to the portion of payment:

Accepted Answer

A)   Paid by the customer
B)   Reimbursed by insurance companies
C)   Paid by the pharmacy
D)   All of the aboveE) A) and B)
F) C) and D)

Exam 13: Pharmacy Billing and Inventory Management

The name a company assigns to a commercial drug product for marketing and identification purposes is called the _____________ name.

Correct AnswerverifiedShow Answer

Which of the following medications may require a prior authorization before adjudicating the prescription claim?

Correct AnswerverifiedShow Answer

Both Medicare and Medicaid were implemented in:

Correct AnswerverifiedShow Answer

Which of the following is not a true statement about PPOs?

Correct AnswerverifiedShow Answer

The processing of claims by insurance companies over a computerized system is called:

Correct AnswerverifiedA

When a workers' compensation claim prescription is presented to the pharmacy, the technician should:

Correct AnswerverifiedShow Answer

An innovator product is a:

Correct AnswerverifiedShow Answer

Which part of Medicare helps pay for physicians' services and outpatient care?

Correct AnswerverifiedShow Answer

The amount to be charged to the insured patient for a prescription is decided by the ______________.

Correct AnswerverifiedShow Answer

Medicare Part D specifically covers:

Correct AnswerverifiedShow Answer

Which one of the following illnesses is the patient not exempt from insurance company limitations?

Correct AnswerverifiedShow Answer

What term refers to the portion of the prescription bill that the patient is responsible for paying?

Correct AnswerverifiedShow Answer

The information needed by insurance companies to process a claim from the pharmacy or to reimburse the patient is the same as the information required on a pharmacy label, plus:

Correct AnswerverifiedShow Answer

A system that automatically tracks inventory is:

Correct AnswerverifiedShow Answer

Prescription coupon cards are issued by:

Correct AnswerverifiedShow Answer

Which of the following types of patients would not be eligible for Medicare coverage?

Correct AnswerverifiedD

Point-of-sale (POS) billing allows the insurance company to:

Correct AnswerverifiedShow Answer

Mail-order companies usually fill up to a __________ supply for certain maintenance drugs.

Correct AnswerverifiedShow Answer

PPO means :

Correct AnswerverifiedB

The term third-party billing refers to the portion of payment:

Correct AnswerverifiedShow Answer

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A

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D

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B

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