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  2. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    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]

  3. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  4. Insurers try not to deny patients prescription drugs. Here's ...

    www.aol.com/insurers-try-not-deny-patients...

    Nationwide, prescription drugs are the costliest and commonly used heath plan benefit. Last year, BlueCross spent more than $3 billion on medications for our members. Every one of those dollars ...

  5. Special prescription form - Wikipedia

    en.wikipedia.org/wiki/Special_prescription_form

    Special prescription forms, sometimes called narcotic prescription forms, controlled prescription forms, psychotropic prescription forms or triplicate prescription forms (because they often have to be signed in triplicate) are forms required in some countries for the prescription of controlled narcotics and other psychotropic substances, for which a standard medical prescription is not sufficient.

  6. Marketing authorisation - Wikipedia

    en.wikipedia.org/wiki/Marketing_authorisation

    In most countries, a marketing authorisation is valid for a period of 5 years. After this period, one should apply for renewal of the marketing authorisation, usually by providing minimal data proving that quality, efficacy and safety characteristics are maintained and the risk-benefit ratio of the medicinal product is still favourable.

  7. Step therapy - Wikipedia

    en.wikipedia.org/wiki/Step_therapy

    Step therapy, also called step protocol or a fail first requirement, is a managed care approach to prescription.It is a type of prior authorization requirement that is intended increase insurance company profits at the expense of patient health by forcing patients onto lower cost prescription drugs.

  8. Expanded access - Wikipedia

    en.wikipedia.org/wiki/Expanded_access

    Expanded access or compassionate use is the use of an unapproved drug or medical device under special forms of investigational new drug applications (IND) or IDE application for devices, outside of a clinical trial, by people with serious or life-threatening conditions who do not meet the enrollment criteria for the clinical trial in progress.

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    mail.aol.com

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