Understanding the financial side of pharmacy practice is just as important as knowing medications. This Pharmacy Technician Financial Issues Quiz reviews essential concepts such as third-party billing, insurance claims, prior authorizations, copays, reimbursement models, and the role of PBMs (pharmacy benefit managers).
Designed for pharmacy tech students preparing for certification exams or real-world workflows, this quiz helps you master the behind-the-counter systems that impact patient access and pharmacy revenue.
Disclaimer: This quiz is for educational review only and is not affiliated with PTCB, ExCPT, or any certifying organization.
Co-insurance
Managed care programs
MAC
Co-pays
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Worker's compensation
UNIVERSAL CLAIM FORM
TIER
All the above
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CMS-1500 form
CMS - 10114 form
Co-insurance
Co-pay
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Formulary
Dual co-pay
Co-pay
Co-insurance
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Medication Therapy Management Services (MTMS)
National Provider Identifier (NPI)
Online adjudication
Deductible
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Co-insurance
Co-pay
Maximum allowable cost
Usual and customary price
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The patient is on medicare
The patient has a mail order program
The person code entered does not match the birth date and/or sex in the insurer's computer
The patient is on medicaid
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Cms-1500 form
Cms-10114 form
Co-pay
Co-insurance
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Dual co-pay
Co-insurance
Pos
Prior authorization
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Prescription drug plans (pdps)
Prescription drug benefit cards
Universal claim form
Worker's compensation
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The same amount
Less
More
None of the above
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A list of medications that are covered by a third party program
An official compendium of the FDA
A listing of the ingredients in a prescription
The price of a prescription under third party program
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Medicaid
Hmo
Medicare
Ppo
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Birth date
Weight
Sex
Group number
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Online adjudication
Medicaide
Medicare
Co-pay
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HMO's
Maximum allowable cost (MAC)
Dual co-pay
Co-insurance
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The insurance plan has a closed formulary
The insurance plan has an open formulary
The birth date submitted does not match the birth date in the insurer's computer
The patient has mail order
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The insurer has an incorrect birth date for the patient
The patient's coverage has expired
The connection with the insurer's computer is temporarily unavailable due to computer problems
The insurer has a closed formulary
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HMO's
Medication Therapy Management Services ( MTMS )
National Provider Identifier (NPI)
Fromulary
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Medicaid
Medicare
Midication therapy management services (MTMS)
None of the above
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Pharmacy benefit mangers
Prescription drug benefit cards
Patient assistance programs
Universal claim from
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ICD-9
MAC
PPO
99605,99606, and 99607
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Cms-1500 form
Cms-10114 form
Co-insurance
Co-pay
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Third party
Co-insurance
MAC
UCR
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Open formulary
Closed formulary
Formulary
None of the above
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Pharmacy benefit managers
MACs
HMOs
Employers
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U&C or UCR
POSs
PPOs
Tier
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Prescription drug benefit cards
Prescription drug plans pdps
Ppos
Pos
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4
2
1
3
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Co-insurance
Co-pay
Deductible
Dual co-pay
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Tier
Pos
Pdps
Ppo
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MAC
Dual co-pay
Co-insurance
Co-pay
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Pharmacy benefit managers
POSs
Prescription Drug Plans PDPs
Universal claim form
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Telephone the insurance plan's pharmacy help desk
Immediately refer the problem to the pharmacist
All the above
None of the above
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Medicare
Ppo
Medicaid
Hmo
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Dual co-pays
MAC
Duplicate pricing
UCR
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Hmo
Pharmacies
Physicians
Pharmaceutical manufacturers
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A universal claim form (UCF)
A pdf
An NDC
Cms-1500
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Medicare
Ppo
Medicaid
Hmo
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PPOs
POSs
U&C or UCR
Tier
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The retail price of the drug
The manufacturer's cost
A wholesaler's price
None of the above
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Online adjuication
Medicare
Medicaid
None of the above
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POSs
Ppos
Pdps
None of the above
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POS
HMO
MAC
PPO
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Quiz Review Timeline (Updated): Jun 24, 2025 +
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