Certification of Pharmacy Technicians (ExCPT) Practice Exam

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What does a "Rejected Claim" with "Unable to Connect" typically mean?

The insurer has an incorrect birth date for the patient
The patient's coverage has expired
The connection with the insurer's computer is temporarily unavailable
The insurer has a closed formulary

The correct answer is: The connection with the insurer's computer is temporarily unavailable

A "Rejected Claim" marked as "Unable to Connect" indicates that there was a communication failure between the pharmacy and the insurer's computer system at the time the claim was being processed. This could be due to network issues, server outages, or other technical difficulties that prevent a successful connection to verify patient information and coverage details. This choice reflects a common scenario in health care transactions, where electronic systems need to interact seamlessly. If the connection isn’t established, the claim cannot be processed, leading to a status of "Reject." Understanding this helps pharmacy technicians address technical issues promptly, ensuring that they can either reattempt the claim or seek help to rectify the connection problem. This option emphasizes the importance of connectivity in the claims process, while the other choices relate to specific patient or policy details that would not inherently cause an inability to connect.