Exam 2 - Ops and Svcs pt 2

Question 1

What is a “niche market”?

Answer 1

It is a service that can be developed to fill a niche in the community pharmacy setting - fulfilling an unmet need

Question 2

What does SWOT stand for?

Answer 2

Strengths
Weaknesses
Opportunities
Threats

Question 3

Medicare Part A

Answer 3

Inpatient hospital stays, skilled nursing care, some home health care, and hospice care

Question 4

Medicare Part B

Answer 4

Doctor visits, lab tests, medical equipment, outpatient medical serviced, and some preventive care –diabetic testing supplies

Question 5

Medicare Part C

Answer 5

Medicare advantage plans are offered by private insurance companies approved by Medicare, covering all of the services listed in Parts A and B and typically Part D. It’s a privately-administered alternative to being enrolled in Original Medicare (Parts A and B)

Question 6

Medicare Part D

Answer 6

Prescription drug coverage

Question 7

DME criteria - Medicare

Answer 7

payor: Medicare
usable life: greater than or equal to 3 years
purpose of use: Medical
pt status: not useful in pt who is not sick/injured
location of use: home

Question 8

DME criteria - Medicaid

Answer 8

payor: Medicaid
usable life: greater than or equal to 3 yrs
purpose of use: Medical
pt status: not useful in pt who is not sick/injured
location of use: home & community

Question 9

DME criteria - managed care

Answer 9

payor: managed care
“plan specific” for all other criteria

Question 10

DMEPOS

Answer 10

Durable medical équipement, prosthetics, orthotics, and supplies