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Chapter 8 Quiz Flashcards | StudBud
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Chapter 8 Quiz
Chapter 8 Quiz
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1
coordination of benefits (COB)
In person billing of primary and a secondary insurer
Faxed insurer
Uninsured Patient
online billing of both a primary and a secondary insurer
2
Who is considered the third party in terms of payment of prescriptions?
the guardian
the insurance company
the patient
the personal representative
3
The pharmacy is notified of a charge-back due to an incorrect coordination of benefits. Who loses the money?
The Pharmacy
the patient
the PBM
the insurer
4
What federal act established drug benefits for senior citizens on Medicare?
Affordable Care Act of 2010
Medicare Modernization Act of 2003
Balanced Budget Act of 1997
Social Security Act of 1965
5
What information on a patient's prescription card tells the technician which PBM is administering the drug plan?
patient ID
Group number
bank identification number
processor control number
6
In the tiered copayment system, the patient pays
a different fee up front depending on the expense level of the service.
more for office visits than for emergency room visits.
the same for all services.
nothing--all is covered by the insurance
7
Which step in processing a claim does the technician learn if a drug is on the formulary for a specific insurance plan?
on-line adjudication
insurance audit
insurance card data entry
DUR process
8
Which federal program provides healthcare to United States citizens over 64 years of age and those who are disabled?
CHIP
Tricare
Medicaid
Medicare
9
When an employee is injured on the job, the Pharmacy tech will bill the prescription services related to the injury to
the patient
the patient's private health insurance.
workers' compensation insurance
the employer.
10
What does AWP Stand for?
access without perscription
Average Wholesale Price
All Weather Pitch
Add With Perscription
11
Technicians should remind patients it is time to renew their healthcare exchange insurance during what months?
January to February
November to January
All of these answers are correct.
September to November
12
If your insurance is a Preferred Provider Organization (PPO) and you go to a provider out-of-network, you will
get a discounted rate
pay higher copays and fees
need to use a different formulary
not be covered
13
Tricare is government insurance for active military, veterans, and military dependents.
False
True
14
A patient with low income, who is uninsured, should be referred to the__to select and purchase a low-cost plan.
COBRA
Federal Medicare Website
the state's on-line Affordable Care healthcare exchange
free clinic
15
What is workers compensation (Insurance)?
All of these are correct.
A set aside amount of money to pay for medical expenses.
A budget for workers
Cover health problems related to one's job.
16
Which of the following is considered preventive care and covered by most insurance plans?
immunizations
perscriptions
medical equipment
OTC drugs
17
A group number is information on the insurance card that identifies the employer sponsor of the drug insurance program
True
False
18
Medicare part B pays for partial coverage of prescriptions, primarily for patients who are eligible for Medicare
True
False
19
uninsured patient
Medicare part B
Patients with insurance
Medicare Part D
patient with no insurance who pays out of pocket for health costs
20
Under the Affordable Care Act, a business with more than ______full-time employees must offer healthcare insurance.
100
25
50
200
