PTCE PTCE Billing and Reimbursement

Question 1

What does DAW stand for in pharmacy billing?

Accepted Answer

Dispense As Written

Answer

Drug Authorization Waiver

Answer

Dispensing Approval Workflow

Answer

Drug Availability Warning

Question 2

What is the primary purpose of a prior authorization (PA) in pharmacy billing?

Accepted Answer

To obtain insurance approval before dispensing a specific medication

Answer

To expedite dispensing

Answer

To verify the patient's identity

Answer

To confirm the pharmacy's license

Question 3

What is the BIN number on a pharmacy insurance card used for?

Accepted Answer

To route prescription claims to the correct insurance processor

Answer

To identify the patient's date of birth

Answer

To verify the pharmacist's license

Answer

To look up drug pricing

Question 4

What does a pharmacy formulary contain?

Accepted Answer

A list of drugs covered by an insurance plan

Answer

A list of licensed pharmacies

Answer

A schedule of pharmacist salaries

Answer

A record of patient prescriptions

Question 5

What is coordination of benefits (COB) in pharmacy billing?

Accepted Answer

A process that determines payment order when a patient has two insurance plans

Answer

Combining two prescriptions into one fill

Answer

Transferring a prescription between pharmacies

Answer

Adjusting the days supply on a claim

Question 6

What does the PCN number on an insurance card identify?

Accepted Answer

Processor Control Number used to route claims

Answer

Patient Control Number for identification

Answer

Pharmacy Chain Number for the dispensing location

Answer

Prescription Code Number for the drug