MedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledFormularyakapreferreddrug listPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsDurableMedicalEquipmentDMEAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsAverageWholesalePriceAWPTricareinsurance foractive andretiredmembers of themilitary andtheir familiesPreferredProviderOrganizationsPPOsCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersFlexibleSpendingAccountFSACopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65Charge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsHealthSavingsAccountHSAworker'scompcovers illnessor injuriescaused by orrelated toone's jobPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionCMNcertificateof medicalnecessityNPINationalProviderNumberMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsin-networkprovidersthose withwhom theinsurance co.has a workingcontractDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inReferralofficialapprovedconsent fromthe pcp foradditionalservicesBINbankidentificationnumberMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BHealthMaintenanceOrganizationsHMOsPCNprocessorcontrolnumberMedicarePart Ahospitalcoverage foranyone over65 ordisabledMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledFormularyakapreferreddrug listPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsDurableMedicalEquipmentDMEAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsAverageWholesalePriceAWPTricareinsurance foractive andretiredmembers of themilitary andtheir familiesPreferredProviderOrganizationsPPOsCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersFlexibleSpendingAccountFSACopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65Charge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedOnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsHealthSavingsAccountHSAworker'scompcovers illnessor injuriescaused by orrelated toone's jobPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionCMNcertificateof medicalnecessityNPINationalProviderNumberMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsin-networkprovidersthose withwhom theinsurance co.has a workingcontractDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inReferralofficialapprovedconsent fromthe pcp foradditionalservicesBINbankidentificationnumberMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BHealthMaintenanceOrganizationsHMOsPCNprocessorcontrolnumberMedicarePart 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. prescriptions drug coverage for anyone over 65 or disabled
    Medicare Part D
  2. covers doctor's visits for anyone over 65 or disabled
    Medicare Part B
  3. aka preferred drug list
    Formulary
  4. division of insurance co. that processes pt. rx claims
    Pharmacy Benefit Manager
  5. DME
    Durable Medical Equipment
  6. checking of the pharmacy's prescription records to challenge problems
    Audit
  7. AWP
    Average Wholesale Price
  8. insurance for active and retired members of the military and their families
    Tricare
  9. PPOs
    Preferred Provider Organizations
  10. nongovernmental, private insurance that they pay for on their own or subsidized by their employers
    Commercial Insurance
  11. FSA
    Flexible Spending Account
  12. flat out-of-pocket fee that pt. is required to pay for each health visit
    Copay
  13. offers the full package of hospital, doctor visits, and rx drug insurance for anyone over 65
    Medicare Part C
  14. post-claim rejection of a rx claim by a PBM that must be investigated
    Charge-back
  15. electronically submitting rx claims to the appropriate PBMs
    Online Adjudication
  16. HSA
    Health Savings Account
  17. covers illness or injuries caused by or related to one's job
    worker's comp
  18. PBM wants to communicate with the dr. to get more information about the ongoing need for a prescription
    Prior Authorization (PA)
  19. certificate of medical necessity
    CMN
  20. National Provider Number
    NPI
  21. coverage for low-income, disabled, unemployed run by federal and state governments
    Medicaid
  22. those with whom the insurance co. has a working contract
    in-network providers
  23. amount of annual medical costs that must be paid before full coverage by insurance co. kicks in
    Deductible
  24. official approved consent from the pcp for additional services
    Referral
  25. bank identification number
    BIN
  26. supplemental plan from a private insurance company to help cover Medicare A & B
    Medigap insurance
  27. HMOs
    Health Maintenance Organizations
  28. processor control number
    PCN
  29. hospital coverage for anyone over 65 or disabled
    Medicare Part A