MedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65Charge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedFormularyakapreferreddrug listMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& Bin-networkprovidersthose withwhom theinsurance co.has a workingcontractAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsDurableMedicalEquipmentDMEHealthMaintenanceOrganizationsHMOsCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitFlexibleSpendingAccountFSAMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inBINbankidentificationnumberAverageWholesalePriceAWPHealthSavingsAccountHSAMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledPCNprocessorcontrolnumberReferralofficialapprovedconsent fromthe pcp foradditionalservicesTricareinsurance foractive andretiredmembers of themilitary andtheir familiesPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionPreferredProviderOrganizationsPPOsworker'scompcovers illnessor injuriescaused by orrelated toone's jobCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledNPINationalProviderNumberCMNcertificateof medicalnecessityMedicarePart Ahospitalcoverage foranyone over65 ordisabledMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65Charge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedFormularyakapreferreddrug listMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& Bin-networkprovidersthose withwhom theinsurance co.has a workingcontractAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsDurableMedicalEquipmentDMEHealthMaintenanceOrganizationsHMOsCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitFlexibleSpendingAccountFSAMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inBINbankidentificationnumberAverageWholesalePriceAWPHealthSavingsAccountHSAMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledPCNprocessorcontrolnumberReferralofficialapprovedconsent fromthe pcp foradditionalservicesTricareinsurance foractive andretiredmembers of themilitary andtheir familiesPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionPreferredProviderOrganizationsPPOsworker'scompcovers illnessor injuriescaused by orrelated toone's jobCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledNPINationalProviderNumberCMNcertificateof medicalnecessityMedicarePart Ahospitalcoverage foranyone over65 ordisabled

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