7 Prescription Processing Online Quiz Questions

True

False

Enter the most likely directions based on common practice.

Refer the order to the pharmacist for clarification with the prescriber.

Use the patient’s recollection to fill in the missing directions.

Submit the claim using directions from a similar prescription.

Determine the correct segment format and add a leading zero to the short segment when converting for a transaction that requires 11 digits.

Always add a zero to the beginning of the entire NDC, regardless of its segment format.

Check the package code against the actual product package.

Verify the submitted NDC against the product selected for dispensing.

Change the directions to increase the days’ supply shown on the claim.

Check the previous fill, directions, quantity, and days’ supply, then follow applicable procedures.

Select a different product so the claim will pass.

Resubmit repeatedly without checking the claim history.

True

False

Use the 12-digit format for all current HIPAA reimbursement transactions.

Add a zero to the start of every 10-digit NDC and submit the resulting number without checking its segments.

Use the required 11-digit, 5-4-2 format for the HIPAA reimbursement transaction, applying the zero to the correct short segment.

Use the package code from any package containing the same active ingredient.

For an eligibility or coverage rejection, recheck patient and plan information and confirm the appropriate payer.

For a prior-authorization rejection, follow the pharmacy’s process to contact the prescriber or plan.

For an NDC mismatch, select a different product solely to force the claim to pay.

For an NDC mismatch, verify the actual product and package and correct the claim data.

Use the fixed-schedule formula without adjustment for every product.

Check the product-specific calculation or day-supply rules and escalate uncertainty to the pharmacist.

Assume the package size determines the prescribed quantity.

Change the prescribed duration to match the payer’s preferred days’ supply.

Enter the most likely directions based on common practice.

Refer the unclear order to the pharmacist for clarification with the prescriber.

Change the directions to match the pharmacy system and proceed.

Process the order and ask the patient to confirm the directions at pickup.

True

False

Use clear patient-facing directions that accurately reflect the authorized order.

Keep shorthand codes on the label even when patients may not understand them.

Simplify the directions by removing special instructions from the order.

Use directions from a prior fill if they are easier to read.

Match the drug name and package size; the other product details can be checked after dispensing.

Match the active ingredient and strength, while treating dosage form and release characteristics as optional.

Confirm that the active ingredient, strength, dosage form, route, and release characteristics are appropriate.

Choose the product that is covered by the payer, even if its release characteristics differ.

Resubmit the claim with a longer days’ supply without checking the prescription.

Check the previous fill, directions, quantity, and days’ supply, then follow procedures for a legitimate exception.

Change the quantity to fit the payer’s timing edit and dispense the altered amount.

Tell the patient that the medication cannot be dispensed under any circumstances.