Tricareinsurance foractive andretiredmembers of themilitary andtheir familiesNPINationalProviderNumberBINbankidentificationnumberMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitHealthSavingsAccountHSADurableMedicalEquipmentDMEAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsPCNprocessorcontrolnumberMedicarePart Ahospitalcoverage foranyone over65 ordisabledFlexibleSpendingAccountFSAPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inCMNcertificateof medicalnecessityReferralofficialapprovedconsent fromthe pcp foradditionalservicesin-networkprovidersthose withwhom theinsurance co.has a workingcontractOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65PriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionFormularyakapreferreddrug listHealthMaintenanceOrganizationsHMOsMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedAverageWholesalePriceAWPPreferredProviderOrganizationsPPOsworker'scompcovers illnessor injuriescaused by orrelated toone's jobTricareinsurance foractive andretiredmembers of themilitary andtheir familiesNPINationalProviderNumberBINbankidentificationnumberMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitHealthSavingsAccountHSADurableMedicalEquipmentDMEAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsPCNprocessorcontrolnumberMedicarePart Ahospitalcoverage foranyone over65 ordisabledFlexibleSpendingAccountFSAPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inCMNcertificateof medicalnecessityReferralofficialapprovedconsent fromthe pcp foradditionalservicesin-networkprovidersthose withwhom theinsurance co.has a workingcontractOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65PriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionFormularyakapreferreddrug listHealthMaintenanceOrganizationsHMOsMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedAverageWholesalePriceAWPPreferredProviderOrganizationsPPOsworker'scompcovers illnessor injuriescaused by orrelated toone's job

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.


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