Insurance and Patient Costs
The sharing of expenses by the policyholder and the insurance company
What is coinsurance?
A complete list of items such as property, goods in stock, or the contents of a building.
What is inventory?
To check the accuracy of financial accounts and records.
What is audit?
The average price at which drugs are purchased at the wholesale level.
What is average wholesale price?
Equipment that provides therapeutic benefits to a patient in need because of certain medical conditions and/or illnesses.
What is durable medical equipment?
The portion of the cost of a prescription that the patient is responsible for paying when part of the cost is covered by a third-party payer
What is copayment?
The total value of the entire stock of products on hand for sale on a given day.
What is inventory value?
Net sales minus the cost of goods sold.
What is gross profit?
A formulary provided by an insurance company that indicates preferred prescription generic and brand name drugs and their corresponding co-pays.
What is preferred drug list?
Consumable, disposable items that can only be used by one patient for a specific purpose.
What is nondurable medical supplies?
The amount you must pay before you begin receiving any benefits from your insurance company.
What is deductible?
The amount of time the average drug inventory will be replaced during a 12-month period; most pharmacies replace inventory every two to four weeks
What is inventory turnover rate?
The difference between the purchase price and the selling price; also called gross profit.
What is mark up?
An organization that manages prescription drug benefits on behalf of health insurers.
What is pharmacy benefit manager?
Real-time insurance claims processing via wireless telecommunications.
What is online adjudication?
Insurance coverage in which a patient pays one co-pay for brand name drugs and a lower co-pay for generic drugs
What is dual copay?
Purchasing items as needed
What is Just in Time Purchasing?
Transferring information from a journal entry to a ledger account.
What is posting?
Approval for coverage of a high-cost medication or a medication not on the insurer's approved formulary.
What is prior authorization?
A process to ensure that the benefits are appropriately distributed when a patient is covered by more than one insurance plan.
What is coordination of benefits?
A federal and state assistance program that pays for health care services for people who cannot afford them.
What is Medicaid?
A record that tracks the quantity of, and cost assigned to, inventory items as they are purchased and sold
What is Perpetual Inventory Record?
A transaction returned through a credit card processing interchange by an issuer to an acquirer.
What is charge bark?
A United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries.
What is medicare - part d prescription drug coverage?
Medicare Part D coverage gap.
What is donut hole?