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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. Centene Corporation - Wikipedia

    en.wikipedia.org/wiki/Centene_Corporation

    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 .

  4. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    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.

  5. 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 .

  6. Electronic prescribing - Wikipedia

    en.wikipedia.org/wiki/Electronic_prescribing

    Prescribe or add new medication and select the pharmacy where the prescription will be filled. Work with an existing medication within the practice, this can involve viewing details of a medication, remove a medication from the active medication list, change dose, etc., for a medication or renew one or more medications; Printing prescriptions

  7. Emergency Use Authorization - Wikipedia

    en.wikipedia.org/wiki/Emergency_Use_Authorization

    An Emergency Use Authorization (EUA) in the United States is an authorization granted to the Food and Drug Administration (FDA) under sections of the Federal Food, Drug, and Cosmetic Act as added to and amended by various Acts of Congress, including by the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA), as codified by 21 U.S.C. § 360bbb-3, to allow the use of a ...

  8. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former president Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [7]

  9. Implementation history of the Affordable Care Act - Wikipedia

    en.wikipedia.org/wiki/Implementation_history_of...

    The average beneficiary in the prior coverage gap would have spent $1,504 in 2011 on prescriptions. Such recipients saved an average $603. The 50 percent discount on brand name drugs provided $581 and the increased Medicare share of generic drug costs provided the balance. Beneficiaries numbered 2 million [17]

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