1/15/2025 1:33:33 AM	PHARM 152 Course Outline as of Fall 2019	Changed Course
CATALOG INFORMATION
Discipline and Nbr:  PHARM 152	Title:  AMBULATORY PRACTICE
Full Title:  Ambulatory Pharmacy Practice
Last Reviewed:12/12/2023

Units		Course Hours per Week			Nbr of Weeks	Course Hours Total
Maximum	2.00	Lecture Scheduled	1.50		17.5 max.	Lecture Scheduled	26.25
Minimum	2.00	Lab Scheduled	2.50		17.5 min.	Lab Scheduled	43.75
		Contact DHR	0			Contact DHR	0
		Contact Total	4.00			Contact Total	70.00
		Non-contact DHR	0			Non-contact DHR Total	0

Total Out of Class Hours:  52.50

Total Student Learning Hours: 122.50

Title 5 Category:  AA Degree Applicable
Grading:  Grade Only
Repeatability:  00 - Two Repeats if Grade was D, F, NC, or NP
Also Listed As: 
Formerly: 

Catalog Description:

An overview of the skills needed to operate effectively in an ambulatory setting, with emphasis on receiving and controlling inventory, computerized prescription processing, medical insurance billing, and customer relations.

Prerequisites/Corequisites:
Course Completion or Current Enrollment in PHT 150 ( or PHARM 150)

Recommended Preparation:
Eligibility for ENGL 100 or ESL 100

Limits on Enrollment:

Schedule of Classes Information
Description:

An overview of the skills needed to operate effectively in an ambulatory setting, with emphasis on receiving and controlling inventory, computerized prescription processing, medical insurance billing, and customer relations.

(Grade Only)
Prerequisites:Course Completion or Current Enrollment in PHT 150 ( or PHARM 150)
Recommended:Eligibility for ENGL 100 or ESL 100
Limits on Enrollment:
Transfer Credit:
Repeatability:00 - Two Repeats if Grade was D, F, NC, or NP

ARTICULATION, MAJOR, and CERTIFICATION INFORMATION

Associate Degree:		Effective:		Inactive:
Area:
CSU GE:	Transfer Area			Effective:	Inactive:
IGETC:	Transfer Area			Effective:	Inactive:
CSU Transfer:		Effective:		Inactive:
UC Transfer:		Effective:		Inactive:
C-ID:

Certificate/Major Applicable: Both Certificate and Major Applicable

COURSE CONTENT

Student Learning Outcomes:
At the conclusion of this course, the student should be able to:

1.  Demonstrate correct utilization of specific computer software used in ambulatory

    pharmacies.

2.  Accurately compute the charge for a prescription based on the cost price of the drug and the

    professional fee, identify the customer's payment methods, and demonstrate a working

    knowledge of insurance billing to include Federal, State and private medical insurance.

Objectives:

Upon successful completion of this course, students will be able to:

1. Evaluate purchase invoices and assess them for error.

2. Electronically confirm Third Party coverage for a prescription.

3. Verify Third Party claim forms for a prescription by phone when necessary. Complete Third

    Party claim forms. Properly record the payment for pharmaceuticals.

4. Create patient paper and electronic profiles utilizing information obtained from the

    prescription and the patient.

Topics and Scope

I. Prescription Pricing in the Retail Setting

    A. Medication cost

    B. Professional/dispensing fee

    C. Mark-up

    D. Percent Mark-up

    E. Overhead

    F. Turnover

    G. 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

         3. co-pay procedures and record keeping

         4. handling rejects

         2. 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

         3. CHAMPVA

         4. 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. Formulary Usage. Recording Sales. Treatment

      Authorization Requests (TARS). Charge-back and Reject Summary Reports and Patient

      Profiles.

VIII. Utilize pharmacy computer database system to enter and retrieve accurate data, generate

      labels and patient information.

Assignments:

Lecture-Related Assignments:

1. Create patient profiles manually and electronically

2. 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

3. Ten pages of reading per week

4. Answer questions at the end of each chapter on calculating the charge for prescriptions based

    on cost of drug and professional fee (not graded)

5. Learn 10-20 brand/generic drug names and their usage per week (not graded)

6. Weekly quizzes, 1-2 exams, final exam

 

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

Methods of Evaluation/Basis of Grade.

Writing: Assessment tools that demonstrate writing skill and/or require students to select, organize and explain ideas in writing.		Writing 30 - 40%
Written homework, patient profiles
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.		Problem Solving 0 - 0%
None
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.		Skill Demonstrations 30 - 40%
Customer communication skills; Lab activities
Exams: All forms of formal testing, other than skill performance exams.		Exams 30 - 40%
Quizzes, exam(s), final exam
Other: Includes any assessment tools that do not logically fit into the above categories.		Other Category 0 - 0%
None

Representative Textbooks and Materials:

Pharmacy Practice for Technicians. 6th ed. Ballington, Don and Anderson, Robert. Paradigm Publishing. 2017

Medical Insurance for Pharmacy Technicians. Liles, Janet and Newby, Cynthia. McGraw-Hill. 2010 (classic)

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