CVS Assessment Insurance and Prescription Processing Questions and Answers Flashcards
6 cards from real CVS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CVS Assessment Insurance and Prescription Processing Questions and Answers flashcards as text
A customer's insurance card shows two plans. Which is billed first?
Answer: The primary insurance is billed first; the secondary insurance is billed for any remaining balance
Coordination of benefits rules require the primary plan to be billed first; the secondary plan covers remaining eligible costs.
A prescription is written for 'metoprolol 50 mg tabs, #90, 1 tab daily.' What is the correct days supply to enter?
Answer: 90 days
90 tablets taken at 1 tablet per day equals exactly 90 days supply.
What does the acronym 'BIN' stand for on a pharmacy insurance card?
Answer: Bank Identification Number
BIN stands for Bank Identification Number and routes the electronic claim to the correct pharmacy benefit manager (PBM).
A patient is covered by Medicaid. Which special consideration applies at CVS?
Answer: Medicaid has specific formularies and quantity limits that the system enforces; co-pays are often $0 or very low
State Medicaid programs impose strict formulary controls and often have $0 or minimal co-pays for eligible beneficiaries.
When a prescription is transferred from another pharmacy, what information must be obtained?
Answer: The complete original prescription information, dispensing history, and remaining refills from the transferring pharmacy
Federal and state law require a full transfer record including original prescription details and remaining refills to be documented.
What is the purpose of the 'PCN' number on a pharmacy benefit card?
Answer: It is a secondary routing code that helps direct the claim within a PBM's system
PCN (Processor Control Number) works with BIN to route the claim to the correct adjudication system within the PBM.
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