Question 1

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

Accepted Answer

A)  Adjudication 
B)  Adjustment 
C)  Computerization 
D)  Instant processing 
A)  Adjudication 
B)  Adjustment 
C)  Computerization 
D)  Instant processing A

Question 2

PPO means :

Accepted Answer

A)  Preferred provider option 
B)  Preferred provider organization 
C)  Preferred physician option 
D)  Preferred physician organization 
A)  Preferred provider option 
B)  Preferred provider organization 
C)  Preferred physician option 
D)  Preferred physician organization B

Question 3

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 babies 
A)  Disabled patients 
B)  Senior citizens 
C)  Dialysis patients 
D)  Healthy babies D

Question 4

Both Medicare and Medicaid were implemented in:

Accepted Answer

A)  1965 
B)  1975 
C)  1985 
D)  1995 
A)  1965 
B)  1975 
C)  1985 
D)  1995

Question 5

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 company 
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 company

Question 6

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-day 
A)  90-day 
B)  120-day 
C)  150-day 
D)  180-day

Question 7

Medicare Part D specifically covers:

Accepted Answer

A)  Prescription medications 
B)  Surgery 
C)  Physicians' visits 
D)  Physical therapy 
A)  Prescription medications 
B)  Surgery 
C)  Physicians' visits 
D)  Physical therapy

Question 8

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. 
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.

Question 9

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 above 
A)  Paid by the customer 
B)  Reimbursed by insurance companies 
C)  Paid by the pharmacy 
D)  All of the above

Question 10

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 filling 
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 filling

Question 11

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

Question 12

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 above 
A)  trade 
B)  brand 
C)  proprietary 
D)  all of the above

Question 13

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)  Furosemide 
A)  Amoxicillin/clavulanate 
B)  Botox 
C)  Conjugated estrogens 
D)  Furosemide

Question 14

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)  Cancer 
A)  Diabetes 
B)  Acquired immunodeficiency syndrome (AIDS) 
C)  Human immunodeficiency virus (HIV) 
D)  Cancer

Question 15

A system that automatically tracks inventory is:

Accepted Answer

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

Question 16

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 D 
A)  Medicare Part A 
B)  Medicare Part B 
C)  Medicare Part C 
D)  Medicare Part D

Question 17

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 above 
A)  Pharmacy 
B)  Patient 
C)  Insurance company 
D)  None of the above

Question 18

Prescription coupon cards are issued by:

Accepted Answer

A)  Drug manufacturers 
B)  Medicare 
C)  PBMs 
D)  All of the above 
A)  Drug manufacturers 
B)  Medicare 
C)  PBMs 
D)  All of the above

Question 19

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)  Premium 
A)  Coinsurance 
B)  Copayment 
C)  Deductible 
D)  Premium

Question 20

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

Exam 13: Pharmacy Billing and Inventory Management

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

PPO means :

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

Both Medicare and Medicaid were implemented in:

An innovator product is a:

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

Medicare Part D specifically covers:

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

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

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

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:

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

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

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

A system that automatically tracks inventory is:

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

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

Prescription coupon cards are issued by:

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

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

History of Medicine and Pharmacy

Pharmacy Law, Ethics, and Regulatory Agencies

Competencies, Associations, and Settings for Technicians

Communication and Role of the Technician With the Customerpatient

Dosage Forms and Routes of Administration

Conversions and Calculations

Drug Information References

Community Pharmacy Practice

Institutional Pharmacy Practice

Additional Pharmacy Practice Settings

Bulk Repackaging and Non-Sterile Compounding

Aseptic Technique and Sterile Compounding

Medication Safety and Error Prevention

Pharmacy Operations Management

Drug Classifications

Therapeutic Agents for the Nervous System

Therapeutic Agents for the Endocrine System

Therapeutic Agents for the Musculoskeletal System

Therapeutic Agents for the Cardiovascular System

Therapeutic Agents for the Respiratory System

Therapeutic Agents for the Gastrointestinal System

Therapeutic Agents for the Renal System

Therapeutic Agents for the Reproductive System

Therapeutic Agents for the Immune System

Therapeutic Agents for Eyes, Ears, Nose, and Throat

Therapeutic Agents for the Dermatologic System

Therapeutic Agents for the Hematologic System

Over-The-Counter Otc Medications

Complementary and Alternative Medicine Cam

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