CPhT CPhT Insurance and Billing

Question 1

What does 'DAW' stand for on a prescription?

Accepted Answer

Dispense As Written

Answer

DAW (Dispense As Written) indicates the prescriber requires the brand-name drug and no generic substitution is allowed.

Question 2

What is a pharmacy benefit manager (PBM)?

Accepted Answer

A third-party administrator that manages prescription drug benefits

Answer

A PBM is a third-party administrator that manages prescription drug benefits on behalf of health insurers, employers, and other payers.

Question 3

What is a formulary?

Accepted Answer

A list of approved medications covered by an insurance plan

Answer

A formulary is a list of prescription drugs covered by a health insurance plan, typically organized into tiers based on cost.

Question 4

What does 'prior authorization' (PA) require?

Accepted Answer

Approval from the insurance company before dispensing certain medications

Answer

Prior authorization requires the prescriber to obtain approval from the insurance company before a specific medication will be covered.

Question 5

What is a copayment in pharmacy billing?

Accepted Answer

A fixed amount the patient pays for a prescription

Answer

A copayment is a fixed dollar amount the patient pays out-of-pocket for each prescription at the time of dispensing.

(CPhT) Certified Pharmacy Technician Practice Test