| TERM |
DEFINITION |
| AAC |
Actual
acquisition cost: PharmaCare pays the actual drug cost as
indicated by the dispensing pharmacy. AAC is adjusted to
reflect the true cost to the pharmacy and is net of any cash
discounts, volume discounts, rebates or performance allowances. |
| Access
Record |
A record
showing who has accessed a patient's record in the previous
fourteen months for purposes other than filling a prescription,
as well as the date and time of each access. |
| Adjudicate |
Decide
about a claim based on a set of rules or polices. Refer to claims
adjudication. |
| Adjudication
Date |
The date,
as determined by the processor, on which the claim, transaction
or request being responded to has been adjudicated. |
| Adverse
Drug Reaction |
A negative
reaction to a particular drug or excipient. This definition
includes allergic reactions to a drug. |
| AHFS |
American
Hospital Formulary Service. |
| Annual
Family Maximum |
To protect
your family from excessively high prescription costs, an
annual family maximum has been set. Once your contributions
towards eligible costs reach this maximum, PharmaCare will
pay 100% of your family's further eligible prescription costs
for the remainder of the calendar year. |
| Batch |
Multiple
transactions sent as a single group on PharmaNet for processing
at once; transmitted when PharmaNet is back on-line after
a network interruption. |
| BC
Controlled Prescription Program - Duplicate Pads |
A College
of Physicians & Surgeons peer review program that focuses
on the appropriate use of opioids for which a Duplicate Prescription
is required. |
| Benefit |
A drug
or product defined by a Drug Identification Number (DIN)
or Product Identification Number (PIN) which is eligible
for full or partial payment by PharmaCare. |
| Brand
Drug Name |
A patented
medication produced by a brand name drug company. |
| Capitation
Rate |
A monthly,
per-patient rate that PharmaCare pays to pharmacists in lieu
of dispensing fees. |
| Cardholder |
A patient
holding a valid CareCard. |
| CareCard |
A card
issued by the Ministry of Health to each British Columbia
resident registered with the Medical Services Plan. The CareCard
shows the cardholder's unique Personal Health Number. |
| Change
Window |
A scheduled
PharmaNet outage - usually from 12:01 a.m. to 8:00 a.m. every
Thursday - during which time technical staff perform routine
and scheduled maintenance on PharmaNet. |
| CITS |
Common
Information Technology Services division of the Ministry
of Management Services. |
| Claim |
A request
to PharmaCare, submitted manually or on PharmaNet, for payment
of the cost of providing a product or service. |
| Claims
Adjudication |
Routines
within PharmaNet having specific functions to determine the
response to (including payment status of) a claim submitted
on PharmaNet. |
| Claims
History |
A record
of claims and expenditure information for each patient. The
claims history is contained in the PharmaCare Centralized
Information System (PCIS) component of PharmaNet and contains
the most recent six months. |
| Class |
All the
differently named products containing the same amount of
the same drug. |
| CLHIA |
Canadian
Life and Health Insurance Association: As a trade association,
the CLHIA exists to serve its member companies in areas of
common need and concern, providing leadership by acting in
their best interests and those of the public. |
| Client
Registry |
Information
maintained by the Ministry of Health, including databases
and access routines, intended to keep track of persons and
organizations served by, or providing service to, the Ministry.
The Client Registry is the control point for issuing of new
Personal Health Numbers. |
| CMBC |
College
of Midwives of British Columbia. |
| CoB
Router |
Coordination
of Benefits Router. A component of the PharmaNet System which
accepts a pharmacy-submitted prescription record and automatically
routes it to and from the appropriate application systems
of PharmaNet. |
| College
of Pharmacists of British Columbia (CPBC) |
The licensing
and regulatory body for the profession of pharmacy and its
practice environment, obtaining authority from the Pharmacists,
Pharmacy Operations and Drug Scheduling Act. Membership
of the College is comprised of pharmacists registered in
British Columbia. |
| College
of Physicians and Surgeons of British Columbia (CPSBC) |
The governing
and licensing body for physicians and surgeons of B.C. |
| Compliant
Software |
Software
on a local system which has been evaluated by PharmaCare
and found to comply with all related requirements for connection
to PharmaNet. |
| Confidentiality
Undertakings |
Agreements
signed by pharmacists as part of the pharmacist registration
process with the CPBC. Also, forms specific to each pharmacy
which are signed by the pharmacy staff members involved in
the dispensing process to ensure that they understand and
comply with confidentiality procedures. |
| Co
-pay or Co-payment |
Under
the Fair PharmaCare plan, once your family reaches the deductible,
PharmaCare will pay a percentage of further eligible prescription
costs for the remainder of the year. The co-pay is the amount
your family will be required to contribute towards the eligible
costs of a prescription after PharmaCare has covered its
portion. |
| CPhA |
Canadian
Pharmacists Association: National voluntary organization
of pharmacists self-mandated to promote the profession of
pharmacy |
| CPBC |
College
of Pharmacists of British Columbia |
| CPSBC |
College
of Physicians and Surgeons of British Columbia |
| CSR |
Client
Service Representative at the PharmaNet Help Desk. |
| Deductible |
Under
the Fair PharmaCare plan, your family is responsible for
100% of prescription costs until your payments towards eligible
prescription costs reach the deductible. Once your family
reaches the deductible, PharmaCare will assist your family
in paying for further eligible costs for the remainder of
the calendar year. (Families with very low income may not
be required to meet a deductible.) |
| Demographic
Information |
Basic,
non-clinical information about an individual recorded on
PharmaNet, usually including full name, gender, address,
postal code, and telephone number. |
| Dependent
Child |
For PharmaCare
purposes, a child is a resident who is the legal ward or
child of the registrant or spouse, is supported by the registrant
or spouse, is neither married nor living and cohabiting in
a marriage-like relationship, and is either age 18 or younger
or age 19 to 24 and attending school or university full-time.
The child must also be included in your (or your spouse's)
Medical Services Plan coverage and must not currently be
registered with PharmaCare as a member of another family. |
| DIN/GP# |
A number
assigned to each drug product marketed under the Food and
Drug regulations by the Health Protection Branch of Health
Canada. The DIN identifies only one product. |
| DIS |
PharmaNet
Drug Information System. |
| DND |
Department
of National Defence. |
| DOB |
Date of
birth. |
| Dosette
Packaging |
Single
doses packaged individually, e.g., in blister packs. |
| Drug
Cost / Product Value |
Total
cost of ingredients in a prescription, or total value of
supplies issued. |
| Drug
Identification Number (DIN) |
A number
assigned to each drug product marketed under the Food and
Drug regulations by the Health Protection Branch of Health
Canada. The DIN identifies only one product. |
| Drug
Information System (DIS) |
A component
of PharmaNet that contains the patient record and drug information.
Access to DIS is controlled by the College of Pharmacists
of British Columbia. |
| Drug
Monograph |
Clinical
data available on PharmaNet that provides the pharmacist
with information on the proper use, side effects, etc., of
the medication being dispensed. Often, a monograph contains
educational or counseling information intended to be understood
by and printed out for a patient. |
| Drug
Use Evaluation (DUE) |
Information
on potential drug therapy and dispensing problems, which
PharmaNet provides. Also called Drug Utilization Review (DUR). |
| Electronic
Funds Transfer (EFT) |
A payment
by PharmaCare that is deposited electronically into a pharmacy
designated account at a bank or credit union. Also called
'direct deposit'. |
| EIA |
Ministry
of Employment and Income Assistance |
| Encryption |
The process
of encoding data to prevent unauthorized access to the data,
especially during transmission on a network. |
| Escalation
Procedure |
A procedure
followed by the PharmaNet Help Desk in responding to a problem
call. The steps of the procedure for a particular problem
call depends on the severity level assigned. |
| Fan-out |
A means
of broadcasting urgent messages on PharmaNet to specific
groups connected to PharmaNet. |
| Family |
Under
Fair PharmaCare, a
family consists of you, your spouse and dependent children,
if applicable. |
| Field |
A space
on a PharmaNet screen where specific information is entered. |
| Fill |
The only
filling of a particular prescription by a pharmacist. For
multi-fill prescriptions, the terms first-fill and refill
are used. |
| First
DataBank (FDB) |
An independent
agency that supplies drug monograph information to PharmaNet. |
| Gateway |
A device
that connects networks so that information can be both transferred
and converted to a form compatible with the receiving network. |
| Generic
Drug |
A medication
that is chemically equivalent to an existing brand name medication
and is manufactured by a generic drug company to compete
with the brand name product. |
| Gold
CareCard |
A card
issued by the Ministry of Health to each British Columbia
resident registered with the Medical Services Plan who is
65 years of age or older. The CareCard shows the cardholder's
unique Personal Health Number. |
| GP# |
General
product identification number assigned to a drug product
by the Health Protection Branch of Health Canada. |
| Host |
The main
computer in a system of computers or terminals connected
by communication links, in this case PharmaNet. |
| HUB |
In a network,
a device joining communication lines at a central location,
providing a common connection to all devices on the network. |
| ICBC |
Insurance
Corporation of British Columbia. |
| INAC |
Indian
and Northern Affairs Canada. |
| Interface |
The point
at which two or more systems meet, e.g., hardware and software,
software and software, and the means by which those systems
communicate. A 'user interface' is the point at which a human
and a computer interact. |
| Internet
Protocol (IP) |
Communications
standards that govern the breakup of data messages into packets,
the routing of the packets over the Internet from the sender
to the destination, and the re-assembly of the packets into
the original data messages at the destination. |
| Intervention/Exception
Codes |
Canadian
Pharmacists Association (CPhA) approved codes that the pharmacist
may enter on PharmaNet to override normal adjudication rules
when appropriate, e.g., when submitting reversals or overriding
a duplicate prescription. |
| Investigational
Drug |
This is
an obsolete term. Refer to Special Access Program (SAP) drug. |
| IVR |
Interactive
Voice Response system. |
| ITSD |
The former
Information Technology Services Division; now the Common
Information Technology Services division of the Ministry
of Management Services. |
| Keyword |
A word
that a patient can attach to their PharmaNet patient record,
which limits access to only those pharmacists with whom the
patient shares the keyword. |
| LAN |
Local
area network. A network that connects computers that are
close to each other, usually in the same building. The computers
are linked with cables. |
| LCA |
Low Cost
Alternative. |
| LCD |
Liquid
crystal display. |
| LED |
Light
emitting diode. |
| Local
System |
The computer
hardware and software used to support pharmacy services for
a PharmaNet participant. |
| Low
Cost Alternative |
The alternative
with the lowest average price (claimed on PharmaNet) of all
products usually in the same generic class. |
| LTC |
Long-term
Care. |
| Maximum
Days' Supply |
The maximum
number of days worth of treatment paid by PharmaCare for
a prescription, which is either 30 days or 100 days depending
on various circumstances. |
| Medical
Services Plan of British Columbia (MSP) |
A program
of the Ministry of Health, offering universal medical coverage
to British Columbia residents. |
| Medication
History |
Prescription
history for each patient Personal Health Number (PHN). The
medication history table on PharmaNet is part of the Drug
Information System. |
| MHC |
Mental
Health Centre. |
| MHR |
The former
Ministry of Human Resources, now the Ministry of Employment
and Income Assistance. |
| Modem |
A network
communications component provided by PharmaCare to each pharmacy
connected to PharmaNet. |
| MSDES |
Formerly
the Ministry of Social Development and Economic Security,
now the Ministry of Employment
and Income Assistance. |
| Multi-doctoring |
When a
patient, having obtained a prescription from a doctor, seeks
to obtain a prescription from another doctor for an identical
or equivalent drug within a short time period. |
| Non-Insured
Health Benefits (NIHB) |
Federal
government coverage of health benefits provided to First
Nations by Health Canada. |
| NPA |
No Public
Access medications: medications that can be obtained without
a doctor's prescription but that are kept behind the counter
at a pharmacy. |
| Off-line |
Disconnected
from a computer network. |
| O-Meds |
Office-use
medications. |
| On-line
Adjudication |
Processing
of a claim immediately, to determine eligibility (pharmacy,
prescriber, practitioner, pharmacist, and drug), the drug
cost and professional fee claimed, and the cardholder portion.
With on-line adjudication, the claim adjudication result
is sent to the pharmacy's system immediately. |
| OOP |
Out of
Province. |
| OTC |
Over-the-Counter:
medications that can be obtained without a doctor's prescription. |
| Participation
Agreement |
British
Columbia PharmaCare Pharmacy Participation Agreement. |
| PatCOB
Table |
Patient
Coordination of Benefits Table on PharmaNet which contains
the PHNs for all persons whose prescriptions are covered
by certain federal government agencies/programs. |
| Patient
Keyword |
A special
word, determined by the patient, used to control access to
their personal medication history, their patient profile
and printed patient profile. |
| Patient
Record |
Information
recorded regarding a patient, including PHN, demographic
information, medical and clinical information, medication
history, and any adverse drug reaction data. |
| PCIS |
PharmaCare
Centralized Information System. |
| Personal
Health Number (PHN) |
A unique
identification number assigned to each CareCard holder. This
number is used to store and retrieve all patient information
on PharmaNet, including the patient's record. A PHN is required
for recording a prescription on PharmaNet. A PHN does not
necessarily mean eligibility for PharmaCare coverage. |
| PharmaCare |
The British
Columbia government operated prescription drug program. |
| PharmaCare
Centralized Information System (PCIS) |
A component
of PharmaNet that performs claims processing and payment.
Its key functions are to adjudicate claims; reverse claims;
handle off-line claims; and manage payments. Access to PCIS
is restricted to the Ministry of Health. |
| PharmaCare
Information Line |
An automated
method for pharmacists to obtain information from PharmaCare
by telephone. Also called the IVR system. |
| Pharmacist
ID |
Pharmacist
identification number refers to the dispensing pharmacist's
diploma number. CPBC license number. |
| Pharmacy
Remittance Advice Form |
The statement
sent to a pharmacy, dispensing physician/clinic, or non-pharmaceutical
supplierwhen a payment adjustment has been made. For suppliers
not connected to PharaNet the remittance advice details each
payment made to them by PharmaCare. |
| Pharmacy
Software Vendor |
A firm
providing a product to one or more PharmaNet participants
for the purpose of interfacing with PharmaNet. |
| PIN |
Product
Identification Number. |
| Practitioner |
A person
authorized to practice medicine, dentistry, veterinary medicine,
or a prescribed health care profession in which a practitioner
of that profession is authorized to prescribe drugs or devices. |
| Practitioner |
A pharmacist,
physician, surgeon, dentist, podiatrist, midwife, or veterinarian. |
| Practitioner
ID |
A unique
number assigned to practitioner by the practitioner licensing
body, e.g., the College of Physicians and Surgeons of British
Columbia, or the College of Pharmacists of British Columbia. |
| Premium
Assistance |
A program
of the Medical Services Plan (MSP) which provides qualified
(low-income) persons/families with reduced MSP premiums.
Qualification for Premium Assistance is reviewed by MSP on
a yearly basis. |
| Prescriber |
Any health
professional authorized to prescribe medications or treatment
to a patient. In B.C. prescribers include physicians, dentists,
podiatrists, midwives and veterinarians. |
| Product |
An item
that may be requested on a prescription and/or a claim. A
product may or may not be a drug, e.g.., blood glucose monitoring
strips. |
| Product
Identification Number (PIN) |
A PharmaCare
assigned number for a product or compound that does not have
a federally-assigned Drug Identification Number (DIN). |
| Provider |
Supplier
of products and services recognized by PharmaCare,e.g.,
pharmacist, prosthetic supplier. |
| PSV |
Pharmacy
Software Vendor. |
| RDP |
Reference
Drug Program. |
| Record |
A collection
of related data fields. |
| Reference
Drug/Drugs |
The drug
or drugs considered to be equally as efficacious and the
most cost effective in a therapeutic category. |
| Reference
Drug Program |
A PharmaCare
program in which coverage is based on the cost of the reference
drug (or drugs) in a therapeutic category. |
| Registration
and Premium Billing (R&PB) |
The branch
of the Medical Services Plan (MSP) responsible for registering
British Columbia residents for coverage, maintaining client
demographic information, and billing clients for MSP premiums. |
| Resident |
A long
term care (permanent) patient in a licensed adult long term
care (LTC) facility OR a resident of the province of British
Columbia. |
| Respite |
Short
term; as in a respite resident/bed in a long term care facility. |
| Response/Status
Codes |
Standard
CPhA codes attached to claims returned on PharmaNet, providing
information on the status of the claims. |
| Reversal |
The submission
of a transaction to cancel (reverse) a previous transaction.
The reversal can be for a previous PharmaNet transaction
or for a manual transaction. |
| RIP |
Rural
Incentive Program: A program offered by PharmaCare that assists
those pharmacies in isolated communities by paying a subsidy
per prescription to the pharmacy, subject to certain conditions. |
| Rural
Pharmacy |
A pharmacy
is considered rural (or remote) if it is the sole pharmacy
in a community and the next nearest pharmacy is at least
25 km away. |
| SA |
Special
Authority. |
| SAP |
Special
Access Programme. |
| Service
Level Agreement |
The agreement
between HealthNet/BC and each Pharmacy Software Vendor specifying
roles, responsibilities, service standards, and escalation
procedures. |
| SPAN/BC |
The government
Shared Provisional Access Network in B.C. |
| Special
Access Programme (SAP) |
This programme,
administered by the Therapeutic Products Directorate of Health
Canada, is responsible for authorizing the sale of pharmaceutical,
biological, and radio-pharmaceutical products that are not
for sale in Canada. The programme may occasionally allow
physicians to treat patients with drugs not approved for
sale in Canada in cases of serious or life-threatening illness
when conventional therapies have failed, are unsuitable,
are unavailable or offer limited options. |
| Special
Authority |
An exemption
that makes a particular drug eligible for full or partial
PharmaCare benefit. |
| Special
Services Fee |
A fee
PharmaCare may pay to any PharmaNet connected pharmacy that
does not dispense a prescription as a result of information
revealed to the pharmacist by PharmaNet. Also called a professional
intervention fee. |
| Spouse |
For PharmaCare
purposes, a spouse is a person who is either married to or
living and cohabitating in a marriage-like relationship with
the registrant and may be of the same gender as the registrant. |
| Stock
Transfers |
Pharmacy
transactions that include the sale of drug inventories to
other pharmacies, the transfer of inventories to long-term
care facilities, and the return of drugs to wholesalers.
Stock transfers are not PharmaNet transactions. |
| SSO |
Software
Support Organization: A person or organization providing
a product to a HealthNet/BC participant for the purpose of
accessing Ministry applications. Also referred to a Pharmacy
Software Vendor. |
| Supplier |
Supplier
of products and services recognized by PharmaCare, i.e.,
prosthetics. Also called provider. |
| Temporary
Premium Assistance |
A program
administered by the Ministry of Provincial Revenue which
provides qualified (low-income) persons/families with reduced
Medical Service Plan premiums on a short-term basis. |
| Timeout |
A network
interruption that occurs when the PharmaNet host computer
cannot process transactions within a pre-determined length
of time. Timeouts can occur for various reasons. |
| TPD |
Therapeutic
Products Directorate of Health Canada. |
| Transaction |
A standardized
set of computer messages sent on PharmaNet by a pharmacy
local system when a prescription is processed. |
| Transaction
- TAC/TDU |
This is
the Fill a Prescription transaction. The TAC portion
of the TAC/TDU transaction on PharmaNet represents the financial
component of a claim, and the TDU portion of the Drug Use
Evaluation (DUE) component. To process a full prescription,
both the TAC and TDU portions must be transmitted together
on PharmaNet. The TAC portion cannot be independently transmitted. |
| Transaction
- TCP |
This Patient
Keyword Maintenance transaction is used by the pharmacist
to enter a patient keyword on PharmaNet when the patient
creates or changes the keyword. The TCP transaction cannot
be used to remove the patient keyword. |
| Transaction
- TID |
This Patient
Identification transaction on PharmaNet is used by
the pharmacist to validate the patient's demographic information,
including PHN. |
| Transaction
- TIP |
This Prescriber
Identification transaction on PharmaNet is used to
obtain information on a practitioner by searching either
by the practitioner name or by the unique identification
number assigned to the practitioner by the appropriate
regulatory body. |
| Transaction
- TMU |
The Medication
Update transaction is used by authorized hospital Emergency
Department staff and Medical Practitioner staff to update
a patient's record. |
| Transaction
- TPA |
The Patient
Address Update function/transaction is used by the
pharmacist to update the patient address on PharmaNet.
The patient PHN must be entered on PharmaNet for the existing
address to be found before the address can be updated. |
| Transaction
- TPM |
The Patient
Access to Personal Data function/transaction on PharmaNet
is used by the pharmacist to send a patient request for
PharmaNet medication records to the CPBC. |
| Transaction
- TPN |
The Patient
Name Search transaction is used to find the patient
PHN and record on PharmaNet by entering the patient name,
date of birth, and gender. |
| Transaction
- TRP |
The Retrieve
Full Profile request is used to retrieve all the patient
records. |
| Transaction
- TRR |
The Retrieve
Most Recent request is used to retrieve the most recent
(last 15) entries on a patient record. |
| Transaction
- TRS |
The Retrieve
Filled Elsewhere request is used to retrieve only the
records filled at a different pharmacy. |
| Trial
Drug |
A drug
that is initially dispensed in a trial quantity (14 day supply)
under the Trial Prescription Program. |
| Trial
Prescription Program |
A PharmaCare
program that pays the dispensing fee associated with providing
a small initial quantity of a drug to a consumer who has
not used the drug before, in order to determine whether use
of the drug is effective or subject to adverse side effects. |
| Triplicate
Prescription Program |
See BC
Controlled Prescription Program - Duplicate Pads |
| User
ID |
The name
or alphanumeric code by which the user is identified and
gains access to a computer system or network. |
| VAC |
Veterans
Affairs Canada. Formerly call Department of Veterans Affairs
(DVA). |
| WAN |
Wide Area
Network. |
| WCB |
Workers
Compensation Board. A British Columbia provincial government
agency. |
| Wide
Area Network |
A computer
communications network that connects geographically separated
areas. |
