CMNcertificateof medicalnecessityMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledHealthMaintenanceOrganizationsHMOsFormularyakapreferreddrug listMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65BINbankidentificationnumberMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsHealthSavingsAccountHSADeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inPCNprocessorcontrolnumberworker'scompcovers illnessor injuriescaused by orrelated toone's jobin-networkprovidersthose withwhom theinsurance co.has a workingcontractPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedAverageWholesalePriceAWPPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionTricareinsurance foractive andretiredmembers of themilitary andtheir familiesAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsPreferredProviderOrganizationsPPOsReferralofficialapprovedconsent fromthe pcp foradditionalservicesNPINationalProviderNumberMedicarePart Ahospitalcoverage foranyone over65 ordisabledCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitDurableMedicalEquipmentDMEFlexibleSpendingAccountFSACMNcertificateof medicalnecessityMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledHealthMaintenanceOrganizationsHMOsFormularyakapreferreddrug listMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65BINbankidentificationnumberMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsHealthSavingsAccountHSADeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inPCNprocessorcontrolnumberworker'scompcovers illnessor injuriescaused by orrelated toone's jobin-networkprovidersthose withwhom theinsurance co.has a workingcontractPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedAverageWholesalePriceAWPPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionTricareinsurance foractive andretiredmembers of themilitary andtheir familiesAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsPreferredProviderOrganizationsPPOsReferralofficialapprovedconsent fromthe pcp foradditionalservicesNPINationalProviderNumberMedicarePart Ahospitalcoverage foranyone over65 ordisabledCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitDurableMedicalEquipmentDMEFlexibleSpendingAccountFSA

Pharmacy Insurance Terms - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. certificate of medical necessity
    CMN
  2. prescriptions drug coverage for anyone over 65 or disabled
    Medicare Part D
  3. HMOs
    Health Maintenance Organizations
  4. aka preferred drug list
    Formulary
  5. supplemental plan from a private insurance company to help cover Medicare A & B
    Medigap insurance
  6. electronically submitting rx claims to the appropriate PBMs
    Online Adjudication
  7. offers the full package of hospital, doctor visits, and rx drug insurance for anyone over 65
    Medicare Part C
  8. bank identification number
    BIN
  9. coverage for low-income, disabled, unemployed run by federal and state governments
    Medicaid
  10. HSA
    Health Savings Account
  11. amount of annual medical costs that must be paid before full coverage by insurance co. kicks in
    Deductible
  12. processor control number
    PCN
  13. covers illness or injuries caused by or related to one's job
    worker's comp
  14. those with whom the insurance co. has a working contract
    in-network providers
  15. division of insurance co. that processes pt. rx claims
    Pharmacy Benefit Manager
  16. covers doctor's visits for anyone over 65 or disabled
    Medicare Part B
  17. post-claim rejection of a rx claim by a PBM that must be investigated
    Charge-back
  18. AWP
    Average Wholesale Price
  19. PBM wants to communicate with the dr. to get more information about the ongoing need for a prescription
    Prior Authorization (PA)
  20. insurance for active and retired members of the military and their families
    Tricare
  21. checking of the pharmacy's prescription records to challenge problems
    Audit
  22. PPOs
    Preferred Provider Organizations
  23. official approved consent from the pcp for additional services
    Referral
  24. National Provider Number
    NPI
  25. hospital coverage for anyone over 65 or disabled
    Medicare Part A
  26. nongovernmental, private insurance that they pay for on their own or subsidized by their employers
    Commercial Insurance
  27. flat out-of-pocket fee that pt. is required to pay for each health visit
    Copay
  28. DME
    Durable Medical Equipment
  29. FSA
    Flexible Spending Account