Medical Insurance for Pharmacy Technicians / Edition 1

Medical Insurance for Pharmacy Technicians / Edition 1

5.0 1
by Janet Liles, Cynthia Newby
     
 

ISBN-10: 0073374164

ISBN-13: 9780073374161

Pub. Date: 02/19/2009

Publisher: McGraw-Hill Higher Education

Medical Insurance for Pharmacy Technicians provides a practical, focused overview of medical insurance and billing of prescriptions in the community pharmacy setting. Each chapter is structured to give students a hands-on, practical approach to understanding and working with prescription charges and the billing process. This text is precisely tailored for a

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Overview

Medical Insurance for Pharmacy Technicians provides a practical, focused overview of medical insurance and billing of prescriptions in the community pharmacy setting. Each chapter is structured to give students a hands-on, practical approach to understanding and working with prescription charges and the billing process. This text is precisely tailored for a brief introduction to the fundamental understanding of claim processing principles for pharmacy technicians.

Product Details

ISBN-13:
9780073374161
Publisher:
McGraw-Hill Higher Education
Publication date:
02/19/2009
Edition description:
New Edition
Pages:
192
Sales rank:
341,592
Product dimensions:
8.40(w) x 10.70(h) x 0.40(d)

Table of Contents

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

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Medical Insurance for Pharmacy Technicians 5 out of 5 based on 0 ratings. 1 reviews.
Anonymous More than 1 year ago
i am already a pharmacy technician . i purchased the book to stay up to date. I find them very useful.