Billing & Reimbursement Certificate
The Billing and Reimbursement Certificate demonstrates your proficiency in managing insurance billing and reimbursement in a pharmacy setting. After earning this certificate, you will show your expertise in:
- Insurance programs and eligibility requirements
- Claim processing and adjudication
- Prior authorizations
- CMS audits and contract compliance
Demonstrate Your Advanced Knowledge, Skills & Abilities
- Types of insurance programs
- Processing insurance claims
- Adjudicating insurance claims
- Requesting and processing prior authorizations
- Compliance with insurance contracts
- Insurance audits
Eligibility Requirements
Candidates must be an active CPhT (through either NHA or PTCB) and meet one of the following eligibility requirements to sit for this exam:
Option 1. Completion of a BPTS-Recognized Training Program for Billing & Reimbursement, OR
Option 2. A minimum of 1 year or 1,000 hours of supervised pharmacy experience related to billing and reimbursement.
Recognized Training Programs
The following are BPTS-Recognized Training Programs for the Billing & Reimbursement Certificate Exam:
Additional training programs will be added upon recognition.
*Training providers interested in submitting a program for recognition – click here.
Exam Fee
The exam fee for the Billing & Reimbursement Certificate is $49.
This fee includes one complimentary retake, if required.
How to Apply
To apply for the Billing & Reimbursement Certificate Exam – click here or check out our special launch bundles with courses + exams – here.
Exam Details
The Billing & Reimbursement Certificate Exam is a computer-based exam comprised of 60 multiple choice questions.
Candidates will have 90 minutes to complete the exam and survey.
The exam can be taken at your preferred location, such as at home, and is available online, 24/7.
As a part of the registration process, you will have the opportunity to indicate your need for ADA exam accommodations.
After registration is completed, you will receive an email with instructions on how to complete and submit your request for accommodations.
Taking Your Exam
Instructions will be sent to candidates after applications are reviewed and approved.
Earning Your Certificate & Badge
After passing the exam, you will receive a digital badge and certificate through Credly. This will allow you to print a copy of your certificate and display your digital badge on your resume, your social accounts (LinkedIn, Facebook, Twitter) or even as part of your email signature.
Renewal
The Billing & Reimbursement Certificate does not require renewal.