Rebates Jeopardy

Medicaid

100

Fee For Service is defined as

What is a method in which doctors and other health care providers are paid for each service performed?

200

An MCO is 

What is a health care company or a health plan that is focused on managed care as a model to limit costs, while keeping quality of care high?

300

In Medicaid, analysts will retrieve invoices by these ways

What are download from portal, email, snail mail?

400

AMP and BP are used to calculate what? 

What is URA- Unit Rebate Amount 

500

The three components of the NDC are 

What are labeller code, product code, package size?

Commercial

100

Drug manufacturers enter rebate agreements to

What is achieve preferential formulary status and consistent utilization of their product?

200

The information that would be added to the SmartSheet during Commercial invoice intake is

What is 

Contracted Entity Name

Contract Type

Invoice Frequency

Invoice No. 

Payment Due Date

Total Invoiced Amount 

300

We use these applications and systems to complete invoice intake for Commercial 

What is 

1.) Excel

2.) SmartSheets

3.) SQL

400

All commercial invoices come with these 

What is a “paper invoice,” not all come with the same supporting documentation?

500

A manufacturer pays this percentage fee to the contracted entity for selling/distributing their product 

What is 3-5%?

Tricare/VA

100

You have this many days from the file delivery date

70 days

200

Tricare invoices are billed on this billing schedule 

Monthly

300

This is the correct dispute code for a duplicate claim

What is A?

400

Nonfamp is used for this purpose

The purpose of Non-FAMP is to determine the maximum price of drugs to certain federal agencies

500

SDP and ADp are defined as this 

Standard Discount Program, Additional discount program 

Invoice Intake

100

The types of contracted entities/invoice types Riparian may process Commercial Rebates

What are National Pharmacies, Wholesalers, PBM/GPO/Value-based?

200

In ION, the environment you enter the invoice for is determined by the

Labeller code 

300

True/False: Commercial invoices are only billed on a quarterly basis. 

False...but how are they billed?

400

The Veterans Health Care Act of 1992 established a price cap for sales of covered drugs to the “Big 4”.That price cap is known as

What is the federal ceiling price?

500

The correct TRICARE dispute code for PHS/340B Entity not Extracted from Utilization Data is 

What is K?