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Prior authorization, or preauthorization, [1] is a utilization management process used by some health insurance companies in the United States to determine if they will cover a prescribed procedure, service, or medication.
GSC's was founded in 1957 in Windsor, Ontario. The founder, pharmacist Bill Wilkinson, and four other pharmacists created Canada's first pre-paid drug plan, and started the company as Prescription Services Inc. [4] [5] GSC policies focus on prioritizing evidence-based treatments, [6] [7] preventive care [8] and claims management strategies.
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.
Blue Shield CEO Paul Markovich told Yahoo Finance in an exclusive interview that the new system, based on Salesforce's healthcare cloud system, aims to avoid the pitfalls faced by other insurers ...
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.
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Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
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