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Prior authorization is a check run by some insurance companies or third-party payers in the United States before they will agree to cover certain prescribed medications or medical procedures. [1] There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a generic ...
Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior ...
Accreditation Council for Pharmacy Education (ACPE) is a non-profit accreditation national agency recognized by Council on Higher Education Accreditation and the US Department of Education. [1] It was established in 1932 as the American Council on Pharmaceutical Education and was renamed as the Accreditation Council for Pharmacy Education in ...
In many instances, people needed prior authorization: their doctors had to prove to their Part D plan that the drug was medically necessary for them to get it covered. Health insurers want to ...
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 to control the costs and risks posed by prescription drugs. The practice begins medication for a medical condition with the most cost-effective drug therapy and ...
The North American Pharmacist Licensure Examination (NAPLEX) is a standard examination created by the National Association of Boards of Pharmacy (NABP) to help individual state boards of pharmacy assess an individual's competency and knowledge so that they may be given a license to practice. [1] The NABP has announced that as of November 2016 ...
Utilization management. Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.
The Pharmacy Board of Australia conducts an oral examination at the end of the intern year as the last hurdle prior to registration. The Pharmaceutical Society of Australia provides continuing education programs for pharmacists. The number of full-time equivalent pharmacists working in Australia over the past decade has remained stable. [16]