PTCB Inventory Management & Billing 2

Question 1

What does 'DAW' stand for on a prescription, and what does DAW 1 indicate?

Accepted Answer

Dispense As Written; the prescriber requires the brand-name drug

Answer

Drug Approval Waiver; the drug has prior authorization

Answer

Dispense Alternate Widely; generics are preferred

Answer

Drug Availability Warning; the medication may be on shortage

Question 2

Which government program provides prescription drug coverage primarily for individuals aged 65 and older?

Accepted Answer

Medicare Part D

Answer

Medicaid

Answer

CHIP

Answer

TRICARE

Question 3

What is a 'prior authorization' (PA) in pharmacy billing?

Accepted Answer

Insurance plan approval required before covering a specific medication

Answer

Approval from the state board before dispensing a controlled substance

Answer

A prescriber's approval required before the pharmacy can fill a prescription

Answer

A patient's written consent for a new prescription

Question 4

What does 'adjudication' mean in the context of pharmacy billing?

Accepted Answer

The electronic process of submitting a claim to insurance and receiving payment determination

Answer

The pharmacist's review of a prescription for clinical appropriateness

Answer

The DEA's review of controlled substance prescriptions

Answer

The process of compounding a non-sterile preparation

Question 5

A patient has both primary and secondary insurance. What is 'coordination of benefits' (COB)?

Accepted Answer

The process of determining how two insurance plans share payment responsibility

Answer

The process of splitting a prescription between two pharmacies

Answer

A requirement that both plans must authorize the same medications

Answer

A billing error that results in double payment to the pharmacy

Question 6

What is the 'deductible' in a prescription drug insurance plan?

Accepted Answer

The amount the patient must pay out-of-pocket before insurance begins covering costs

Answer

The fixed dollar amount paid per prescription

Answer

The percentage of drug cost the patient pays after meeting the deductible

Answer

The maximum amount the insurance will pay annually

Question 7

Which term describes the fixed dollar amount a patient pays for each prescription, regardless of the drug's total cost?

Accepted Answer

Copay

Answer

Premium

Answer

Deductible

Answer

Coinsurance