Exam (elaborations)
PTCB - Pharmacy Billing and Reimbursement QUESTIONS AND ANSWERS RATED A+ 2024/2025
- Course
- Institution
PTCB - Pharmacy Billing and Reimbursement QUESTIONS AND ANSWERS RATED A+ 2024/2025
[Show more]
Content preview
PTCB - Pharmacy Billing andReimbursement
Medicare gain (medicare part C) - ANSallows individuals in Medicare Part A and B to gain
insurance thru a Health Maintenance Organization or Preferred Provider Organization that gives
additional services at a better fee.
Medicare part A - ANSa federally funded fitness care program that pays for a affected person's
inpatient hospital care, professional nursing care, hospice care, and domestic fitness care
medicare component B - ANSa federally funded health care application that provides a patient
with coverage for doctor visits, outpatient care, physical therapy, and occupational remedy.
Medicare element D - ANSa federally funded health care application that provides a patient with
coverage for pick out prescription medicinal drugs, scientific resources, insulin, and
vaccinations.
Medicaid - ANSa federal software based totally on profits as well as other situations. Eligibility is
determined on a month with the aid of month foundation. It generally covers medical doctors
visits, emergency care, clinic care, vaccinations, prescriptions, imaginative and prescient,
hearing, and preventative care for kids
common wholesale fee - ANSthe common rate that wholesalers sell a medicine
real acquisition price - ANSactual price a pharmacy paid for a medicinal drug
formulary - ANSa list of medicines accepted for use or reimbursement below a prescription plan.
Open formulary - ANSa style of several medicines in each healing classification
closed formulary - ANSa very confined range of medications available in each healing category,
and occasionally no medicines in certain classifications.
Restrained formulary - ANSa selective, constrained, partly closed formulary in which some
non-formulary medicines are to be had.
On line adjudication - ANSthe manner with the aid of which a pharmacy submits prescription
claims electronically to a third birthday celebration company while filling a prescription to make
sure accurate copayments and timely fee. It permits the pharmacy to verify a patient's eligibility
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller QualityPDF. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
80461 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now