NPINationalProviderNumberTricareinsurance foractive andretiredmembers of themilitary andtheir familiesMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledCMNcertificateof medicalnecessityReferralofficialapprovedconsent fromthe pcp foradditionalservicesFlexibleSpendingAccountFSAPCNprocessorcontrolnumberAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsFormularyakapreferreddrug listDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionDurableMedicalEquipmentDMEworker'scompcovers illnessor injuriescaused by orrelated toone's jobMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicarePart Ahospitalcoverage foranyone over65 ordisabledPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsAverageWholesalePriceAWPMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitHealthSavingsAccountHSAin-networkprovidersthose withwhom theinsurance co.has a workingcontractMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65OnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsHealthMaintenanceOrganizationsHMOsPreferredProviderOrganizationsPPOsMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsBINbankidentificationnumberNPINationalProviderNumberTricareinsurance foractive andretiredmembers of themilitary andtheir familiesMedicarePart Bcoversdoctor's visitsfor anyoneover 65 ordisabledCMNcertificateof medicalnecessityReferralofficialapprovedconsent fromthe pcp foradditionalservicesFlexibleSpendingAccountFSAPCNprocessorcontrolnumberAuditchecking of thepharmacy'sprescriptionrecords tochallengeproblemsFormularyakapreferreddrug listDeductibleamount of annualmedical costs thatmust be paidbefore fullcoverage byinsurance co.kicks inPriorAuthorization(PA)PBM wants tocommunicate withthe dr. to get moreinformation aboutthe ongoing needfor a prescriptionDurableMedicalEquipmentDMEworker'scompcovers illnessor injuriescaused by orrelated toone's jobMedigapinsurancesupplementalplan from aprivate insurancecompany to helpcover Medicare A& BCharge-backpost-claimrejection of arx claim by aPBM that mustbe investigatedCommercialInsurancenongovernmental,private insurancethat they pay foron their own orsubsidized by theiremployersMedicarePart Ahospitalcoverage foranyone over65 ordisabledPharmacyBenefitManagerdivision ofinsuranceco. thatprocessespt. rx claimsAverageWholesalePriceAWPMedicarePart Dprescriptionsdrug coveragefor anyoneover 65 ordisabledCopayflat out-of-pocket fee thatpt. is requiredto pay for eachhealth visitHealthSavingsAccountHSAin-networkprovidersthose withwhom theinsurance co.has a workingcontractMedicarePart Coffers the fullpackage ofhospital, doctorvisits, and rx druginsurance foranyone over 65OnlineAdjudicationelectronicallysubmitting rxclaims to theappropriatePBMsHealthMaintenanceOrganizationsHMOsPreferredProviderOrganizationsPPOsMedicaidcoverage for low-income, disabled,unemployed runby federal andstategovernmentsBINbankidentificationnumber

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