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

DAW (Dispense As Written) codes indicate substitution instructions; DAW 1 means the prescriber specifically requires the brand-name product.

Question 2

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

Accepted Answer

Medicare Part D

Answer

Medicare Part D is the federal prescription drug benefit designed for Medicare beneficiaries, primarily those aged 65 and older.

Question 3

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

Accepted Answer

Insurance plan approval required before covering a specific medication

Answer

A prior authorization is approval from the insurance plan that must be obtained before the plan will cover certain high-cost or non-formulary medications.

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

Adjudication is the real-time electronic process where the pharmacy submits a claim and the insurance plan returns a payment approval or rejection.

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

COB rules determine which insurance plan pays first (primary) and how the secondary plan covers remaining costs to prevent overpayment.

PTCB - Pharmacy Technician Certification Board Practice Test

PTCB - Pharmacy Technician Certification Board Practice Test

PTCB Inventory Management & Billing 2