PHT 53: AMBULATORY PHARMACY PRACTICE
Foothill College Course Outline of Record
Heading | Value |
---|---|
Effective Term: | Summer 2021 |
Units: | 3 |
Hours: | 2 lecture, 3 laboratory per week (60 total per quarter) |
Degree & Credit Status: | Degree-Applicable Credit Course |
Foothill GE: | Non-GE |
Transferable: | CSU |
Grade Type: | Letter Grade Only |
Repeatability: | Not Repeatable |
Student Learning Outcomes
- Demonstrate understanding and implement skills needed to effectively and competently perform a technician job in an ambulatory pharmacy when controlling inventory functions,prescription processing,dispensing and medical insurance.
- Demonstrate and utilize legal and appropriate interpersonal communication skills when interacting with patients, in person and the phone, and pharmacy personnel
Description
Course Objectives
The student will be able to:
A. Accurately calculate the charge for a prescription based on the cost of the drug and the professional fee.
B. Evaluate purchase invoices and assess them for error.
C. Demonstrate a working knowledge of insurance billing to federal, state and private medical insurance.
D. Demonstrate a knowledge of specific pharmacy software that may be used in ambulatory pharmacies or chains of pharmacies.
E. Identify the customer's method of payment for a prescription.
F. Demonstrate a working knowledge of returns, policies and procedures for various ambulatory pharmacy goods.
G. Learn how to utilize different pharmacy manuals and best practices in maintenance of records in the ambulatory pharmacy setting.
H. Demonstrate working knowledge of investigational drugs and the drug development process.
I. Utilize electronic systems to confirm third party coverage for a prescription and complete third party claim forms.
J. Learn and develop professional interpersonal and analytical skills relevant to providing excellent assistance to pharmacists and patients.
K. Learn what non-sterile compounding is, how to use and maintain basic equipment and how to prepare simple creams and ointments.
Course Content
A. Prescription pricing in the retail setting
1. Medication cost
2. Professional/dispensing fee
3. Mark-up
4. Overhead
5. Turnover
6. Depreciation
7. Cash discounts
B. Purchase orders and the invoices for pharmaceuticals and devices
1. Procedures for purchasing
2. Understanding the NDC code
3. Suppliers
4. Receiving orders and verifying specifications
5. Maintenance of inventory
6. Lab: Organizing a retail pharmacy and preparing purchase orders
C. Insurance billing
1. Federal
2. State
3. Private medical insurance
D. Computerized dispensing software
1. General computer functions
2. Computer codes unique to pharmacy
3. Entering and retrieving data
4. Verifying third party coverage
5. Create patient and doctor profiles
6. Generating labels, identifying protected and non-protected patient information
7. Identifying pricing and co-pay information
8. Lab: Use a pharmacy software system to enter and retrieve accurate data, generate labels and prescription backtags
E. Payment methods
1. Insurance
2. Cash
3. Prescription discount cards
F. Returns, policies and procedures for outdates, recalls, damaged goods
1. Adulterated drugs and devices
2. Misbranded drugs and devices
3. Near-expiration prescription drug stocks
G. Ambulatory pharmacy manuals, forms and record keeping
1. Safety data sheets
2. Product inserts and patient product inserts
3. Introduction to on-site reference materials and online reference materials
4. Lab: Learn how to use the relevant reference material to identify information for drug products relevant to an ambulatory setting: pill identification, flavorings, sweetener content, active pharmaceutical ingredient strengths, generic drug ratings
H. Investigational drugs and the drug development process
1. Phase I, II and III of new drug development
2. FDA review process and new drug approval
3. Phase IV
4. Investigational new drugs and their handling and dispensing
I. Third party billing
1. Definition
2. Terminology
3. Information required for digital billing
4. Understanding types of insurance fraud related to pharmacy transactions
5. Cost control methods
a. Brand vs. generic
b. DAW codes
c. Quantity limits
d. Refill intervals
e. Age restrictions
f. Formulary vs. non-formulary
g. Formulary tiers
h. POS
i. Co-pays and deductibles
6. Types of third party payers
a. Private insurers, e.g., Optum, Blue Cross-Blue Shield, etc.
b. Co-pay procedures and record keeping
c. Problem-solving methods to handle common types of rejections
d. CHAMPUS/CHAMPVA
e. Workmen's compensation
f. Medi-Cal
7. Lab: Learning how to extract relevant insurance information for patient profiles and claim adjudication
J. Development of key skills that offer significant impact to customers and pharmacists
1. Define and deliver excellent customer service
2. Define professional ethics and discuss situational problem-solving
3. Develop clear oral and written communication skills
4. Develop an appreciation for:
a. Confidentiality (HIPAA and non-HIPAA-related situations)
b. Dependability
c. Problem-solving
d. Empathy
5. Lab: Role play customer service and problem solving
K. Non-sterile compounding, basic laboratory equipment and equipment maintenance
1. Definition
2. Scope
3. Types of technician roles and responsibilities in non-sterile compounding
4. Description of equipment, how and when to use, and how to maintain
5. Difference between expiration dates and beyond-use dating for compounds
6. Distinction between reconstitution and non-sterile compounding
7. Lab: Translate an oral antibiotic prescription, generate a patient bottle label, follow product directions for reconstitution, then reconstitute and add relevant auxiliary labels for verification by pharmacist. Compound an ointment and generate a professional-looking packaged product
Lab Content
A. Drug organization in pharmacies
B. Communication and customer service skills lab
C. Use of reference materials: Online and hardcopy
D. Prescription translation, computer processing and invoice preparation
E. Third party insurance - information extraction and DAW processing
F. "The Drop-Off Window": Patient and doctor profile generation, DAW processing and insurance processing
G. Introduction to reconstitution and basic non-sterile compounding
Special Facilities and/or Equipment
B. Data sheets specific to clerical duties in the pharmacy and insurance claim forms.
C. College and classroom library with generalized and specialized references.
Method(s) of Evaluation
Objective exams
Lab practical exams
Quizzes
Laboratory reports
Method(s) of Instruction
Lecture presentations and classroom discussion
Small group or team sessions to discuss concepts
Representative Text(s) and Other Materials
American Pharmacists Association, Perspective Press. The Pharmacy Technician, 7th ed.. 2020.
Ballington, Don, and Robert Anderson. Pharmacy Practice for Technicians, 6th ed.. 2017.
Wilson, Billie A., Margaret Shannon, and Kelly Shields. Pearson Nurse's Drug Guide. 2019.
Types and/or Examples of Required Reading, Writing, and Outside of Class Assignments
Weekly reading assignments from text, online curriculum, lab manual, and outside sources ranging from 10-15 pages per week.