worker'scompcovers illnessor injuriescaused by orrelated toone's jobBINbankidentificationnumberMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65HealthMaintenanceOrganizationsHMOsPCNprocessorcontrolnumberPreferredProviderOrganizationsPPOsFlexibleSpendingAccountFSAPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitCMNcertificateof medicalnecessityDurableMedicalEquipmentDMEMedicarePart Ahospitalcoverage foranyone over65 ordisabledMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledAverageWholesalePriceAWPFormularyakapreferreddrug listReferralofficialapprovedconsent fromthe pcp foradditionalservicesPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledNPINationalProviderNumberAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsTricareinsurance foractive andretiredmembers of themilitary andtheir familiesin-networkprovidersthose withwhom theinsurance co.has a workingcontractCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsHealthSavingsAccountHSADeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsworker'scompcovers illnessor injuriescaused by orrelated toone's jobBINbankidentificationnumberMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65HealthMaintenanceOrganizationsHMOsPCNprocessorcontrolnumberPreferredProviderOrganizationsPPOsFlexibleSpendingAccountFSAPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitCMNcertificateof medicalnecessityDurableMedicalEquipmentDMEMedicarePart Ahospitalcoverage foranyone over65 ordisabledMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledAverageWholesalePriceAWPFormularyakapreferreddrug listReferralofficialapprovedconsent fromthe pcp foradditionalservicesPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledNPINationalProviderNumberAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsTricareinsurance foractive andretiredmembers of themilitary andtheir familiesin-networkprovidersthose withwhom theinsurance co.has a workingcontractCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsHealthSavingsAccountHSADeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMs

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