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Medical Insurance for Pharmacy Technicians

Medical Insurance for Pharmacy Technicians

1st Edition
By Janet Liles and Cynthia Newby
Copyright: 2010

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ISBN10: 0073374164 | ISBN13: 9780073374161

$117.00

The estimated amount of time this product will be on the market is based on a number of factors, including faculty input to instructional design and the prior revision cycle and updates to academic research-which typically results in a revision cycle ranging from every two to four years for this product. Pricing subject to change at any time.

Program Details

Chapter 1: From Prescription to Payment: Becoming a Pharmacy Technician Insurance Specialist

The Importance of Pharmacy Benefits

Medical Insurance Basics

The Pharmacy Practice Billing Cycle

Procedures, Communication, and Information Technology in the Pharmacy Billing Cycle

Effects of Pharmacy Claim Errors

Chapter 2: Medicolegal Issues and the Pharmacy

Health Care Regulation

Pharmacy Records

HIPAA Privacy Rule

HIPAA Security Rule

HIPAA Electronic Health Care Transactions and Code Sets

Other Legislation Affecting Pharmacy

Fraud and Abuse Regulations

Pharmacy Question and Answers

Chapter 3: Private Insurance Payers and Plans

Private Insurance

Types of Health Plans

Pharmacy Plan Benefits

Pharmacy Benefit Management Techniques

Calculating Charges

Chapter 4: Medicare

Medicare Overview

Medicare Part B Plans

Who Pays First?

Medicare Part D

Chapter 5: Medicaid, TRICARE, CHAMPVA, Workers’ Compensation, and Discount Card Programs

Medicaid

TRICARE and CHAMPVA

Workers’ Compensation

Discount Card Programs

Chapter 6: Claim Preparation and Transmission

Pricing Prescriptions

Creating Claims

Transmitting Claims

Coordination of Benefits

Chapter 7: Processing Claims and Appealing Decisions

Payer Adjudication of Claims

Collecting Patient Point-Of-Sale Payment

Pharmacy Processing of Payer Claim Payment

Balancing Transactions

Appealing and Resubmitting Claims

Insurer/PBM audits