Pharm Business Test - 3

lebohese's version from 2018-04-04 00:32

Section 1

Question Answer
What is OLTP?On-line Transaction Processing
What does OLTP consist of?Class of information systems that facilitate/manage transaction-oriented apps
Level 1 severity of Drug Interaction is how significant?Least significant - Clinically Significant interaction is not likely
Level 2 severity of Drug Interaction is how significant?Moderately significant - Asses risk & take action as required - interaction likely to occur
Level 3 severity of Drug Interaction is how significant?Significant - Conservative measures are recommended. Potential for severe reaction is great - Little clinical data exists
Days supply allowed is ___ for maintenance drugs?100 days
Maintenance drugs include?Cardiac agents, antibiotics for acne, antidepressants, oral contraceptives
Green Shield max number of days supply?100 days
Number of dispensing fees for GS?5/year
ESI Co-Pay?$0.20 - $15.00
ESI most common Co-Pay?$2.00
How many Drug-Specific Tier options does ESI have?3
What drugs do Tier 1 consist of?Formulary Drugs (Drugs covered on ESI Formulary)
What drugs do Tier 2 consist of?Other Rx Drugs (Not on formulary)
What drugs do Tier 3 consist of?Selected OTC's
What is DTF?Dynamic Therapeutic Formulary - List of drugs reviewed monthly and assessed for therapeutic effectiveness
Tier 1 Provider-Specific Options ESIPreferred Provider Network Pharmacies
Tier 2 Provider-Specific Options ESIMail Order Pharmacies
Tier 3 Provider-Specific Options ESIAll other Pharmacies
NIHB - Non-Insured Health Benefits Program is also known as ___?Indian Affairs
_____ are covered under NIHB regardless of location/income levelAll registered First Nations and Inuit residents
Special Features of NIHB?Funds prescriptions and OTC meds mostly not covered by other tp's
NIHB Members do not pay ___ or ___?CoPayment or Deductible
VAC - Veterans Affairs Canada covers which groupCanadian Forces still serving, RCMP & their dependents and survivors
Benefits for VAC break down into how many "Programs of Choice"14
What does the Special Access Program consist of?Allows doctors access to non-marketed drugs not yet approved for sale
CCO Stands for?Cancer Care Ontario

Section 2

Question Answer
UDConsulted prescriber and changed drug
ULPharmacist decision Rx not filled
UAConsulted prescriber and filled Rx and written
UCConsulted prescriber and changed instructions for use
UBConsulted prescriber and changed dose
UFPatient gave adequate explanation; Rx filled as written
UIConsulted other source; Rx filled as written
UGCautioned patient; Rx filled as written
ULPharmacist decision; Rx not filled
UEConsulted prescriber and changed quantity
MKGood faith emergency coverage established
MNReplacement claim due to dose change
MVVacation Supply
NHInitial Rx program declined
NFOverride - Quantity appropriate

Section 3

Question Answer
ClaimA Demand to the insurer by the insured person for the payment of drug costs under a policy
BenefitThe drugs for which the insurance plan will reimburse costs
DeductibleThe amount that must be paid by the insured before drug benefits become payable by the insurer
Co-payThe portion of the drug cost the insured has to pay
Co-InsuranceInsurer and Insured share a percentage participation - 80/20 ratio
Co-Ordination of BenefitsProcess which families with access to more than one plan sequentially submit their claims to their insurer
ReimbursementRepayment to a beneficiary of the costs incurred to purchase medications