Apr 25

What You Need To Know About Insurance Coverage As A Pharmacy Technician

As a certified pharmacy technician, if you are involved in filling prescriptions, you must be aware that insurance is an integral part of it. It is your job to know how to bill the responsible companies for prescription reimbursement.

Sometimes, problems might crop up in the billing process. As a pharmacy technician, its your job to know how to handle them effectively. You should be knowledgeable about what some common rejections are and how to override them.

It is also possible that your customers ask you some information about the common insurance terms and it would be advantageous if you are aware of such terms and be able to explain it to them in a proper manner. Therefore you should know what a co-payment and deductible is and how to decipher a prescription card.

It would help to become familiar with the prescription drug plans that are accepted at the pharmacy in which you work. Familiarize yourself with each one, perhaps keeping a handy notebook with the deductibles and co-pays for quick reference. In the retail pharmacy environment, technicians often use online billing while submitting claims for subscriptions. Online billing is used because it is a fast method taking just a few seconds to few minutes. However, sometimes problems come up in the billing system which prevents the technician from filling the customer details into the online form. One of such problem is Refill too soon rejection or a prior authorization rejection.

When the pharmacy takes in a new customer, all the related details about him are stored in the database. A staff member will note down the full name, address, date of birth, any medication allergies and make a copy of their prescription card. This prescription card is used for insurance purpose too. You have to be able to decipher the card. All prescription cards contain a BIN number. This is used to identify which insurance company reimburses them for the cost of medication. Most of the prescription cards have an ID and Group number as well.

A co-payment is not the responsibility of the insurer. It is the part of the payment which the patient has to pay from his own pocket. Many companies also utilize a prescription deductible. This is usually in addition to normal co-payments. It means that each year, the customer is responsible for the first $100.00 towards the cost of his or her prescription medications in addition to the co-payments. A deductible refers to the amount which is the patients financial responsibility before their insurance coverage begins.


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