|1. Description - |
|A review of the skills needed to operate effectively in an ambulatory setting, with emphasis on receiving and controlling inventory, processing prescriptions using computerized prescription processing, and medical insurance billing. Customer relations. Intended for students in the pharmacy technology program.|
|Prerequisite: Admission to the Pharmacy Technology Program.|
|2. Course Objectives - |
|The student will be able to: |
- accurately calculate the charge for a prescription based on the cost price of the drug and the professional fee.
- evaluate purchase invoices and assess them for error.
- demonstrate a working knowledge of insurance billing to include Federal, State and private medical insurance.
- demonstrate a knowledge of specific computerized dispensing software packages that may be in use in ambulatory pharmacies or chains of pharmacies.
- identify the customer's method of payment for a prescription.
- demonstrate working knowledge of returns, policies and procedures for various ambulatory pharmacy goods.
- Utilize various forms, manuals and maintain records used in the ambulatory pharmacy setting.
- demonstrate working knowledge of investigational drugs
- utilize electronic systems to confirm Third Party coverage for a prescription and complete Third Party claim forms.
- properly record the payment for pharmaceuticals
- create patient profiles utilizing information obtained from the prescription and the patient.
- provide customer service using interpersonal skills.
|3. Special Facilities and/or Equipment - |
|Textbooks, overhead, videotapes, multimedia cart, charts, computers with pharmacy software programs. Data sheets specific to clerical duties in the pharmacy and insurance claim forms. College Library with generalized and specialized references. |
|4. Course Content (Body of knowledge) - |
- Prescription pricing in the retail setting (L-L)
- Medication cost
- Professional/dispensing fee
- % Mark-up
- Purchase orders and the invoices for pharmaceuticals & devices (L-L)
- Procedures for purchasing
- The "Want Book," shelf stickers and product list
- Understanding the NDC Code.
- Receiving goods and verifying specifications
- Maintenance of inventory
- Lab: Preparing purchase orders and invoices. Receiving and handling procedures and stocking goods.
- Insurance billing (L-L)
- Private medical insurance
- Computerized Dispensing software (L-L)
- General computer functions
- Computer codes unique to pharmacy
- Enter and retrieve data
- Verifying Third Party coverage
- Labels, patient information, and pricing
- Lab: Utilize pharmacy computer data base system to enter and retrieve accurate data, generate labels and patient information.
- Payment methods (L-L)
- Cash discounts
- Trade discounts
- Returns, Policies and procedures for outdates, recalls, damaged goods (L-L)
- Adulterated drugs and devices
- Misbranded drugs and devices
- Ambulatory Pharmacy forms, manuals and records (L-L)
- Materials Safety Data Sheets
- Transfer of Schedule II Controlled Substances among registrants.
- DEA Form 222 - execution and record keeping
- Transfer of Schedule III, IV, and V Controlled Substances.
- Record keeping for Controlled Substances and prescription filing methods.
- PI's and PPI's
- OBRA 1990
- Lab: Maintaining Controlled Substances Records. Prescription Filing
- Investigational Drugs (L-L)
- Special procedures
- Handling and dispensing.
- Third Party billing (L-L)
- Information required for Third Party billing
- Cost control methods
- Brand vs. generic
- DAW Codes
- Quantity limits
- Refill intervals
- Age restrictions
- Dollar amounts
- Formulary vs. non-formulary
- Third Party payers
- Blue Cross-Blue Shield
- Other common providers
- Co-Pay procedures and record keeping
- Handling rejects
- CHAMPUS / CHAMPVA
- Workman's Compensation
- Discount Cards
- Coverage - eligibility
- Lab: Third Party insurance claims and forms. Formulary usage. Recording sales. TAR's. Charge-back and reject summary reports and patient profiles.
- Recording Payments (L-L)
- Policy and procedures
- Patient Profiles (L-L)
- Obtaining pertinent patient information
- Transcribing prescriptions accurately
- Screening for allergies and potential drug interactions
- Problem solving
- Technician functions in assisting pharmacist in improving pharmaceutical care. (L-L)
- Customer Service
- Communicating clearly orally and in writing
- Lab: Role play customer service and problem solving
|5. Repeatability - Moved to header area.|
|6. Methods of Evaluation - |
|The following evaluation methods may be used but are not limited to: |
- Objective exams
- Lab Practical Exams
- Laboratory Notebook
|7. Representative Text(s) - |
American Pharmacists Association, Perspective Press. The Pharmacy Technician. Fourth Edition. Englewood:Morton Publishing Company, 2010.
Wilson, Billie A.,Margaret Shannon, Kelly Shields. Pearson Nurse's Drug Guide. New York: Prentice-Hall, 2013.
|8. Disciplines - |
|Pharmacy Technology |
|9. Method of Instruction - |
- Lecture presentations and classroom discussion regarding topics.
- Small group recitation sessions to discuss concepts.
|10. Lab Content - |
- Drug Organization in Pharmacies
- Communication and Customer Service Practice Skills Lab
- Use of reference material or computer label exercise
- Invoice Preparation
- Med Watch, Adulterated and Misbranded Drugs
- Drug Errors
- Returns & Recalls
- Third Party Insurance
- Third Party record keeping
- Special: CPR Training Session
|11. Honors Description - No longer used. Integrated into main description section.|
|12. Types and/or Examples of Required Reading, Writing and Outside of Class Assignments - |
|Reading Assignments: Weekly reading assignments from text, online curriculum, lab manual, and outside sources ranging from 15 to 20 pages per week. |
|13. Need/Justification - |
|This course is a required core course for the A.S. degree and the Certificate of Achievement in the Pharmacy Technician Program. |