CLO 1
What dosage form is suitable for children?
What type of vitamin interacts with Warfarin?
What are 2 food examples Warfarin interacts with?
Vitamin K, kale and broccoli
List 3 reasons why an insurance will allow early refills
Patient may be leaving the country on extended vacation, in a disaster situation, increase in dosage
What does COB stand for and what does it do?
Coordination of benefits, organizes benefits usually when a patient has two insurances
List 3 types of private insurance plans with their respective meanings
PPO (Preferred Provider Organization)
HMO (Health Maintenance Organization)
EPO (Exclusive Provider Organization)
What does COPD mean? And name 3 types of COPD?
Chronic Obstructive Pulmonary Disease
Chronic bronchitis, pulmonary emphysema, asthma
What is a sublingual and what is transdermal?
Applied under the tongue, a patch
What is the portion on the prescription bill that patients are responsible for paying?
Co-pay
If a patient has both Medicare and Medicaid, which is the primary? What is the difference between Medicare and Medicaid?
Medicare is for people 65 and older, covers certain young people with disabilities, or if the patient is under last stage of renal failure
Medicaid is for low-income family
What is the purpose of the BIN and how may a patient get a not found rejection?
BIN is for routing mechanism in real time for third party claims, and information does not match the patient on file
Name at least 3 common ACE inhibitors
Lisinopril, benazepril, ramipril, enalapril, -pril ending medications
List at least one medication or classification for each disease:
Bladder Instability, Urinary Tract Infection, Chronic Renal Failure, Influenza
Ditropan (oxybutynin)
antibiotics or Phenazopyridine (Pyridium)
diuretics-antihypertensives-antiemetics
cough medicines-decongestants-salt water gargles
List at least 3 types of common reasons for rejected claims:
Coverage expired, coverage limits exceeded, patient refilling too soon, cardholder information doesn't match processor's, invalid days supply
Provide at least ONE use for each parts that Medicare covers. What does DME mean and what Part covers DME?
Part A: inpatient hospital stays, skilled nursing facility stays, some health visits, hospice care
Part B: outpatient visits, medical supplies, medical equipment, some home visits, durable medical equipment (DME)
Part C: Medicare advantage, supplementary benefits
Part D: Drugs
DME: Durable Medical Equipment, Part B
Their primary card holder or their own personal coverage
Personal Insurance
What does CCB mean and at least list 4 common medications
Calcium Channel Blockers
Amlodipine, diltiazem, nifedipine, verapamil, etc
Name at least 2 factors that influence the route of administration of a medication.
What cardiovascular drug requires special IV tubing?
Age, gender, characteristics of the drug, dosage form
Nitroglycerin
If a DUE/DUR or alert pops up, what must the technician do?
Name at least 3 types of medication that require a prior authoriation:
Non-formulary, special treatment medications, outpatient IVs
Wrong day supply, a patient picked up a medication somewhere else
What is the generic for Lipitor?
What are the two kinds of metropolol and what is the usual dosing for each?
What are the two brand names for each metropolol?
atorvastatin
metropolol tartrate, metropolol succinate
Lopressor (tartrate), Toprol XL (succinate)
List at least 3 risk factors for Coronary Heart Disease.
Genetics, age, gender, lifestyle choices
What does NDC mean and what are the 3 sections of NDC?
National Drug code
Labeler code, product code, package code
What is the difference between TRICARE and CHAMPVA?
TRICARE is for veterans, active duty family members, and their dependents
CHAMPVA is for permanently disabled veterans, surviving family of said veterans, or family of veterans that were killed in line of duty
If a patient has dual coverage and the primary covers 65% of the claim, what is the maximum the secondary will cover?
35%