Medical Insurance for Pharmacy Technicians / Edition 1

Medical Insurance for Pharmacy Technicians / Edition 1

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by Janet Liles, Cynthia Newby
     
 

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ISBN-10: 0073374164

ISBN-13: 9780073374161

Pub. Date: 02/19/2009

Publisher: McGraw-Hill 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

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 Education
Publication date:
02/19/2009
Edition description:
New Edition
Pages:
192
Sales rank:
578,765
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.