What system involves the resolution of prescription coverage through the communication of the pharmacy computer with the third party computer?

Study for the PTCB Hospital and Retail Pharmacy Exam. Prepare with flashcards and multiple-choice questions, each with hints and explanations. Ace your certification exam!

The online adjudication system is a processing method that allows pharmacies to verify and resolve prescription coverage instantly through digital communication with third-party payer computers. This system streamlines the process of determining a patient’s eligibility for medication coverage, confirming co-pays, and detailing coverage limits, all in real time.

This immediate exchange of information is crucial for ensuring that patients know their costs and can receive their medications without unnecessary delays. The system improves the efficiency of pharmacists' workloads by reducing paperwork and manual calculations, which are inherent in alternative processing systems.

In contrast, a manual processing system relies on human effort to determine coverage and co-pays, leading to a higher risk of errors and longer patient wait times. The paper claim system is outdated and involves submitting hard copies of claims, which can slow down reimbursement and complicate the administrative process. An automated billing system, while helpful in managing billing tasks, does not specifically pertain to the real-time communication processes with third-party payers for prescription claims. Therefore, the online adjudication system is the most accurate answer in the context of modern pharmacy practice.

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