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Lecture-Related Topics and Scope:
I. Prescription Pricing in the Retail Setting
A. Medication cost
B. Professional/dispensing fee
C. Mark-up pricing
D. Overhead
E. Turnover
F. Depreciation
II. Understanding the National Drug Code
III. Purchase Orders and the Invoices for Pharmaceuticals, Devices, and Supplies
A. Procedures for purchasing
B. The "Want Book", shelf stickers and product list
C. Suppliers
D. Receiving and verifying goods
E. Maintenance of inventory
IV. Discounts
A. Cash discounts
B. Trade discounts
V. Returns, Policies and Procedures for Outdates, Recalls, Damaged Goods
A. Adulterated drugs and devices
B. Misbranded drugs and devices
VI. Safety Data Sheets
VII. Transfer of Schedule II Controlled Substances Among Registrants
A. Registrants
B. Drug Enforcement Agency (DEA) Form 222 - execution and record keeping
VIII. Transfer of Schedule III, IV, and V Controlled Substances
IX. Patient Information and Patient Package Inserts
X. Omnibus Budget Reconciliation Act of 1990 (OBRA '90)
XI. Special Procedures and Documentation for Investigational Drugs
XII. Third Party Billing and Insurance
A. Definitions and terminology
B. Information required for third party billing
1. Coverage
2. Co-pay procedures and record keeping
3. Handling rejects
4. Eligibility
C. Cost control methods
1. Brand vs. generic
2. Dispense-as-written codes
3. Quantity limits
4. Refill intervals
5. Age restrictions
6. Dollar amounts
7. Formulary vs. non-formulary
8. Point of sale
D. Third party payers
1. Blue Cross-Blue Shield
2. other common providers
3. Workers' Compensation
4. discount card programs
E. Government programs
1. MediCAL/Medicaid
2. TRICARE/CHAMPVA
3. Medicare
XIII. Computerized Dispensing Software and Hardware
A. General computer functions
B. Computer codes unique to pharmacies
C. Entering and retrieving data
D. Verifying third party coverage
XIV. Technician Functions in Assisting Pharmacist Toward Improving Pharmaceutical Care
A. Customer service
B. Ethics
C. Communicating clearly, orally and in writing
D. Compassion
E. Confidentiality: Health Insurance Portability and Accountability Act (HIPAA)
F. Dependability
G. Problem solving skills
H. Role-playing with customer service and problem solving
XV. Medicolegal Issues and the Pharmacy
Lab Activities and Content
I. Preparing Purchase Orders and Invoices
II. Receiving and Handling Procedures
III. Stocking Goods
IV. Record Keeping for Controlled Substances Records
V. Maintaining Controlled Substances Records
VI. Prescription Filling
VII. Third Party Insurance Claims and Forms.
A. Formulary usage
B. Recording sales
C. Treatment Authorization Requests (TARs)
D. Charge-back and reject summary reports
E. Patient profiles
VIII. Utilize Pharmacy Computer Database System to Enter and Retrieve Accurate Data, Generate Labels and Patient Information.
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Lecture-Related Assignments:
1. Weekly reading (10-20 pages)
2. Create patient profiles manually and electronically
3. Practice customer communication skills utilizing handouts for:
A. Sales
B. Sample purchase orders
C. Private medical, state, and federal medical billing forms
D. Third party claim forms
4. Learn brand/generic drug names and their usage (10-20 per week)
5. Weekly quizzes, exam(s) (1-2), and final exam
6. Written homework
Lab-Related Assignments:
1. Skill demonstrations of lab activities including:
A. Customer service
B. Ethics
C. Communicating clearly, orally and in writing
D. Compassion
E. Confidentiality: Health Insurance Portability and Accountability Act (HIPAA)
F. Dependability
G. Problem solving skills
H. Role-playing with customer service and problem solving
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Pharmacy Practice for Technicians. 7th ed. Ballington, Don and Anderson, Robert. Paradigm Publishing. 2021.
Law and Ethics for Pharmacy Technicians. 3rd ed. Moini, Jahangir. Cengage Learning, Inc. 2020.
HIPAA for Health Care Professionals. 2nd ed. Krager, Dan and Krager, Carole H. Cengage Learning, Inc. 2018.
Understanding Health Insurance: A Guide to Billing and Reimbursement. 18th ed. Green, Michelle A. Cengage Learning, Inc. 2023.
Pharmacy Labs for Technicians. 4th ed. Sparks, Jason and McCartney, Lisa and Barriera, Nichole and Lubin, Wendy. Paradigm Education Solutions. 2021.
Instructor prepared materials