DME
What does DME stand for?
What is Durable Medical Equipment
What do we call the insurance company?
What is the carrier or insurer
If a patient has not met their deductible, how much will they pay for a $200 prescription?
What is $200
What agency regulates medication guides and labeling requirements?
What is: FDA
How many DAW codes are there?
What is 10?
How are DME claims submitted to Medicare Part B?
What are paper claims
What does a deductible mean?
What is : The amount a patient must pay before insurance starts covering costs.
After meeting a $300 deductible, how much does a patient pay for a $150 prescription with 75% coverage?
What is $37.50?
Which NSAIDs require food to reduce GI side effects?
What are : Celecoxib, naproxen, ibuprofen
What should be documented on the prescription if the doctor/provider insist that a brand name medication is used to fill a prescription?
What is the DAW code number?
What does a pharmacy need to bill DME to Medicare Part B?
What is DMEPOS accreditation or exemption
What is a claim?
What is: A request for reimbursement to the insurance provider.
If a $75 medication has a $25 copay, how much does the insurance cover?
What is $50
Why must nitrofurantoin be taken with food?
What is : It won’t be absorbed and will be ineffective if taken on an empty stomach
A patient has brought in a prescription and the doctor has requested for the generic medication to be dispensed. However, when entering in the medication, the system alerted the pharmacy technician that the generic medication was not available. After the pharmacy technician looked up the medication in the inventory system, the system alerted the pharmacy technician that the medication will be unavailable until further notice, so the technician had to fill the prescription with the brand medication. What DAW code does the pharmacy technician have to use for this prescription?
What is DAW code 8?
Why does reimbursement take longer for DME claims?
What is : Because they are not processed in real time
What is the term for how long a prescription is meant to last?
What is days’ supply
If a prescription costs $200 and insurance pays 75%, how much does the patient owe?
What is $50
What is a reason the FDA might require a medication guide?
What is : Risk of serious side effects or incorrect use.
A patient is given a prescription that states that the generic medication should be dispensed, however, the patient request the brand name medication and lets the pharmacy technician know that they understand that their copay may be higher. What DAW code will the pharmacy technician use?
What is DAW code 2?