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Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.
After a request comes in from a qualified provider, the request will go through the prior authorization process. The process to obtain prior authorization varies from insurer to insurer but typically involves the completion and faxing of a prior authorization form; according to a 2018 report, 88% are either partially or entirely manual. [5]
Centene Corporation is an American for-profit healthcare company based in St. Louis, Missouri, which is an intermediary for government-sponsored and privately insured healthcare programs. Centene ranked No. 25 on the 2023 Fortune 500 .
(Reuters) - Health insurer Cigna Group said on Thursday it would remove the use of prior authorization or paperwork required to get approval for insurance coverage for 25% of medical services.
As with Adobe Acrobat, Nitro PDF Pro's reader is free; but unlike Adobe's free reader, Nitro's free reader allows PDF creation (via a virtual printer driver, or by specifying a filename in the reader's interface, or by drag-'n-drop of a file to Nitro PDF Reader's Windows desktop icon); Ghostscript not needed. PagePlus: Proprietary: No
Old Lyme class action lawsuit, it claims Old Lyme Gourmet Co. labeled certain Deep River brand chips with the “non-GMO ingredients” graphic, giving consumers the impression the snacks were ...
Australian homicide detectives are investigating the suspected "targeted double murder" of a Sydney couple. On Tuesday, Dec. 17., New South Wales (NSW) police confirmed a second body had been ...
Maker-checker (or Maker and Checker or 4-Eyes) is one of the central principles of authorization in the information systems of financial organizations. The principle of maker and checker means that for each transaction, there must be at least two individuals necessary for its completion. While one individual may create a transaction, the other ...