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Multiple Choice Quiz
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1
Many health plans also cover preventive medical services, such as:
A)Prenatal care
B)Annual physical examinations
C)Pediatric and adolescent immunizations
D)All of the above
2
Workers’ compensation cases vary according to:
A)Federal law
B)State law
C)MCO regulations
D)They do not vary
3
A physician would be unlikely to submit a prescription to a pharmacy by which of these methods?
A)Faxing the prescription
B)Electronically submitting the prescription
C)Mailing the prescription
D)Calling in the prescription
4
A remittance advice is also known as a(n):
A)Explanation of benefits
B)Electronic data interchange
C)Pharmacy claim
D)Formulary
5
The final step in the pharmacy billing cycle is:
A)Payer adjudication
B)Patient interview
C)Collections and problem resolution
D)Payment processing
6
A pharmacy claim identifies all of the following except:
A)The prescriber
B)The patient’s symptoms
C)The policyholder
D)The pharmacy sending the claim
7
The balance due on a claim is likely to be paid about how many days after the date of service?
A)Within 30 days
B)30-60 days
C)60-90 days
D)Over 90 days
8
Consultation by the pharmacist is offered on the proper administration of the drug during which step of the pharmacy billing cycle?
A)Point-of-sale patient payment
B)Calculation of payer claim balance
C)Payer adjudication
D)Patient interview
9
An electronic data interchange may be sent during which step of the pharmacy billing cycle?
A)Accounts receivable follow up
B)Payment processing
C)Payer adjudication
D)Pharmacy claim transmittal
10
The payer starts internal processing of the claim for payment to the pharmacy during which step of the pharmacy billing cycle?
A)Payment processing
B)Payer adjudication
C)Calculation of payer claim balance
D)Pharmacy claim transmittal





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