Exam (elaborations)
PTCB - Pharmacy Billing and Reimbursement QUESTIONS AND ANSWERS RATED A+ 2024/2025
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PTCB - Pharmacy Billing and Reimbursement QUESTIONS AND ANSWERS RATED A+ 2024/2025
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PTCB - Pharmacy Billing andReimbursement
Medicare advantage (medicare component C) - ANSallows individuals in Medicare Part A and B
to reap insurance via a Health Maintenance Organization or Preferred Provider Organization
that provides additional services at a higher value.
Medicare element A - ANSa federally funded fitness care application that will pay for a affected
person's inpatient hospital care, skilled nursing care, hospice care, and home fitness care
medicare component B - ANSa federally funded health care program that offers a patient with
coverage for medical doctor visits, outpatient care, physical therapy, and occupational remedy.
Medicare component D - ANSa federally funded fitness care program that gives a affected
person with coverage for choose prescription medicinal drugs, medical materials, insulin, and
vaccinations.
Medicaid - ANSa federal application based on income as well as other circumstances. Eligibility
is decided on a month by way of month foundation. It generally covers docs visits, emergency
care, clinic care, vaccinations, prescriptions, imaginative and prescient, listening to, and
preventative take care of kids
common wholesale charge - ANSthe common price that wholesalers promote a medicinal drug
real acquisition fee - ANSactual price a pharmacy paid for a remedy
formulary - ANSa list of medicines accepted for use or reimbursement beneath a prescription
plan.
Open formulary - ANSa variety of numerous medicinal drugs in every therapeutic category
closed formulary - ANSa very restricted wide variety of medications to be had in each
therapeutic type, and now and again no medicines in positive classifications.
Confined formulary - ANSa selective, limited, partially closed formulary in which a few
non-formulary medicines are available.
On-line adjudication - ANSthe method with the aid of which a pharmacy submits prescription
claims electronically to a third party provider when filling a prescription to make certain accurate
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