Chapter 13 Review Question

Mail-order companies usually fill up to a __________ supply for certain maintenance drugs. a.) 90-day b.) 120-day c.) 150-day d.) 180-day

a.) 90-day

The processing of claims by insurance companies over a computerized system is called: a.) Adjudication b.) Adjustment c.) Computerization d.) Instant processing

a.) Adjudication

Which of the following codes means that the physician has authorized a generic substitution? a.) Dispense as written (DAW) 0 b.) DAW 1 c.) DAW 2 d.) DAW 3

a.) Dispense as written (DAW) 0

Prescription coupon cards are issued by: a.) Drug manufacturers b.) Medicare c.) PBMs d.) All of the above

a.) Drug manufacturers

Which regulatory body can issue a drug recall? a.) FDA b.) TJC c.) DEA d.) BOP

a.) FDA

Which of the following insurance plans requires a PCP? a.) HMO b.) PPO c.) Medicaid d.) All of the above

a.) HMO

Supplemental insurance provided through private insurance companies that help cover costs not reimbursed by Medicare is called: a.) Medigap plan b.) Medifill plan c.) Medisupp plan d.) Mediplus plan

a.) Medigap plan

Medicare Part D specifically covers: a.) Prescription medications b.) Surgery c.) Physicians' visits d.) Physical therapy

a.) Prescription medications

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

A system that automatically tracks inventory is: a.) Ordering cards b.) Automatic dispensing systems (ADS) c.) Handheld inventory computers d.) Bar coding

b.) Automatic dispensing system (ADS)

What is the meaning of AWP? a.) Allowable wholesale price b.) Average wholesale price c.) Average wholesale purchase d.) Acceptable wholesale price

b.) Average wholesale price

Which of the following medications may require prior authorization before adjudicating the prescription claim? a.) Amoxicillin/clavulanate b.) Botox c.) Conjugated estrogens d.) Furosemide

b.) Botox

What term refers to the portion of the prescription bill that the patient is responsible for paying? a.) Coinsurance b.) Copayment c.) Deductible d.) Premium

b.) Copayment

The typical drugs included in a formulary are drugs that are: a.) New b.) Generic c.) Orphan d.) Extremely expensive

b.) Generic

Which part of Medicare helps pay for physicians' services and outpatient care? a.) Medicare Part A b.) Medicare Part B c.) Medicare Part C d.)Medicare Part D

b.) Medicare Part B

An inventory system that automatically orders stocks as it is used is called: a.) Pyxis b.) POS c.) MSDS d.) inventory cards

b.) POS

What is meant by stock rotation? a.) Moving medication shelf displays around the pharmacy to ensure maximum exposure b.) Selling out an item before replacing it c.) Bringing the items with the earliest expiration dates to the front so they are used first d.) Moving items to different places on the shelves

c.) Bringing the items with the earliest expiration dates to the front so they are used first

A pharmacy technician receives a DUE alert; what should they do? a.) Contact the insurance provider b.) Contact the patient c.) Contact the pharmacist d.) Contact the physician

c.) Contact the physician

An innovator product is a: 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

c.) Drug product that was first patented and marketed by the owner of manufacturer

Which one of the following is not a valid reason to return a medication to the warehouse or manufacturer for credit? a.) Drug was recalled b.) Drug expired c.) Drug was incorrectly reconstituted d.) Drug was damaged during delivery

c.) Drug was incorrectly reconsituted

Workers' compensation is paid for by: a.) State government b.) Federal government c.) Employers d.) Employees

c.) Employers

What is one method of medication disposal that patients should be discouraged from using? a.) Wrapping the medication in coffee grounds b.) Wrapping the medication in kitty litter c.) Flushing the medication down the toilet d.) All of the above

c.) Flushing the medication down the toilet

Which health plan covers in-network-provider visits only? a.) A medical group that is covered under Medicare b.) Preferred provider organization (PPO) c.) Health maintenance organization (HMO) d.) Point-of-service plan (POS)

c.) Health maintenance organization (HMO)

Examples of plan limitations include: a.) Days' supply b.) Refill limits c.) Step therapy d.) All of the above

d.) All of the above

Point-of-sale (POS) billing allows the insurance company to: a.) Price a claim b.) Verify eligibility c.) Identify covered drugs d.) All of the above

d.) All of the above

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: a.) Patient's date of birth b.) Insurance group number c.) Insurance identification number d.) All of the above

d.) All of the above

Of the automated systems listed, which is most commonly to manage levels of controlled substances? a.) Pyxis b.) Baker Cell systems c.) Barcoding D.) Both A and C

d.) Both A and C

Which one of the following illnesses is the patient not exempt from insurance company limitations? a.) Diabetes b.) Acquired immunodeficiency syndrome (AIDS) c.) Human immunodeficiency virus (HIV) d.) Cancer

d.) Cancer

What is a PAR level? a.) Periodic automatic replacement b.) Periodic automatic replenishment c.) Periodic adjusted replacement d.) Positive automatic replenishment

b.) Periodic automatic replenishment

Which of the following is responsible for developing the formulary used by an institution? a.) State Board of Pharmacy b.) Pharmacy and Therapeutics committee c.) US Food and Drug Administration d.) All of the above

b.) Pharmacy and Therapeutics committee

PPO means: a.) Preferred provider option b.) Preferred provider organization c.) Preferred physician option d.) Preferred physician organization

b.) Preferred provider organization

The term third-party billing refers to the portion of payment: a.) Paid by the customer b.) Reimbursed by insurance companies c.) Paid by the pharmacy d.) All of the above

b.) Reimbursed by insurance companies

The term third-party billing refers to the portion of payment: a.) Paid by the customer b.) Reimbursed by insurance companies c.) Paid by the pharmacy d.) All of the above

b.) Reimbursed by insurance s companies

Which of the following is not true of flexible spending accounts? a.) The government limits the amount of money a person can put into these accounts each calendar year. b.) The money is there for as long as the person needs it. c.) Restrictions are placed on what services are covered. d.) The plans are similar to a savings account

b.) The money is there for as long as the person needs it

When a workers' compensation claim arrives at the pharmacy, the technician must: a.) obtain permission from a government agency at a later time b.) obtain information from the patient's human resources department c.) collect payment from the patient, who then will be reimbursed from the insurance company d.) wait until payment is made by the insurance company before releasing the medication

b.) obtain information from the patients's human resources department

Reasons why pharmacies return medications to manufacturers include all of the following EXCEPT: a.) medications have been damaged b.) patients return medications c.) the medication is close to its expiration date d.) the drug has been recalled

b.) patients return medications

Third-party billing involves all the following entities EXCEPT: a.) the patient b.) the workplace c.) the pharmacy d.) the insurance companies

b.) the workplace

The amount to be charged to the insured patient for a prescription is decided by the ______________. a.) Pharmacy b.) Patient c.) Insurance company d.) None of the above

c.) Insurance company

What is meant by a back-ordered item? a.) The item is automatically replaced by the wholesaler on a weekly basis. b.) The item must be reordered since it did not arrive with the order. c.) The ordered item is not currently in stock but will be sent as soon as it is available. d.) The item has been discontinued.

c.) The ordered item is not currently in stock but will be sent as soon as it is available

Insurance claims that are transmitted electronically to the insurance provider are called: a.) e-mail claims. b.) NDC claims. c.) adjudicated claims. d.) co-pay claims.

c.) adjudicated claims

Insurance claims that are transmitted to the insurance provider electronically are called: a.) e-mail b.) NDC claims c.) adjudication d.) copays

c.) adjudication

Medicare is a government-managed insurance program that covers all of the following except: a.) senior citizens. b.) patients using dialysis. c.) children. d.) people who are disabled.

c.) children

Medicare is a government-managed program that covers all the following EXCEPT: a.) senior citizens b.) persons using dialysis c.) children d.) persons who are disabled

c.) children

Prescriptions can be filled for ____ days maximum with the authorization of the prescriber and health plan. a.) 30 b.) 60 c.) 90 d.) all of the above

d.) all of the above

The name a company assigns to a commercial drug product for marketing and identification purposes is called the _____________ name. a.) trade b.) brand c.) proprietary d.) all of the above

d.) all of the above

Various types of agents ordered for a pharmacy may include: a.) formulary drugs. b.) hazardous substances. c.) cytotoxic drugs. d.) all of the above.

d.) all of the above

The proper storage of medication is the responsibility of: a.) the inventory technician b.) the pharmacist in charge c.) the technician d.) everyone working in the pharmacy

d.) everyone working in the pharmacy

Information required by insurance companies does not include the: a.) date the prescription is filled b.) name of the pharmacy filling the prescription c.) name and dosage form of drug d.) name of the technician

d.) name of the technician

Which of the following is not a reason for the insurance company to reject a claim? a.) Refill is requested too early. b.) Policy has expired. c.) Patient's identification does not match the processor's information. d.) Claim is a formulary medication.

d.) Claim is a formulary medication

Which of the following is not a government-managed program? a.) Medicare b.) Medical c.) TRICARE d.) Health maintenance organization (HMO)

d.) Health maintenance organization (HMO)

Which of the following types of patients would not be eligible for Medicare coverage? a.) Disabled patients b.) Senior citizens c.) Dialysis patients d.) Healthy babies

d.) Healthy babies

Which program makes prescription drugs available through private insurance company? a.) Medicare Part A b.) Medicare Part B c.) Medicare Part C d.) Medicare Part D

d.) Medicare Part D

Medicaid covers all of the following persons except: a.) people who are disabled. b.) people with a low income. c.) women who are pregnant. d.) single working persons with above-average income.

d.) single working persons with above-average