Failed pharmacy billing section twice — what am I missing for the exam?

by Amanda H. 200 views3 replies
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Amanda H.OP
May 27, 2026

So I'm sitting here staring at my second failed attempt on the billing and insurance section of my pharmacy tech certification and honestly I'm at a loss. I've been studying for about six weeks now, maybe 2-3 hours a night, and I feel like I understand the material when I'm reading it but then the actual questions on the exam trip me up every time. My target score is a 75 to pass and I keep landing around 62-64.

The thing is, the concepts seem straightforward — adjudication, coordination of benefits, prior authorizations — but the application questions are where I fall apart. A friend recommended I work through the Pharmacy Pharmacy Billing and Insurance practice test to get a feel for how questions are actually worded. Has anyone else found that pharmacy practice tests with realistic question formats made a big difference? I feel like my study guide isn't cutting it alone.

Any exam tips from people who've already passed this section would be seriously appreciated. Especially around COB scenarios and Medicare Part D — those destroy me every time.

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Chris D.
May 28, 2026
COB scenarios are brutal until they just... click. What helped me was drawing out a flowchart for primary vs. secondary payer logic every time I practiced. Also — don't underestimate how much terminology the exam tests. I probably spent two full weeks just drilling definitions before I started doing full practice tests. Once I did that, my scores jumped almost 10 points.
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Jessica L.
May 28, 2026
Honestly the gap between knowing the material and answering exam-style questions is real. I had the same problem. What format is your study guide? If it's mostly reading with chapter quizzes, you might need something with more exam-like question banks. Also worth looking at the pharmaceutical chemistry sections even if that's not where you're struggling — sometimes cross-topic stuff shows up in billing questions.
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Sofia R.
May 28, 2026
Medicare Part D tripped me up too. The thing that finally helped: memorize the coverage gap thresholds cold — like actually write them out from memory daily. That one habit probably saved me 3-4 questions on my actual exam. You've got this.

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