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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 .
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.
Authorization hold (also card authorization, preauthorization, or preauth) is a service offered by credit and debit card providers whereby the provider puts a hold of the amount approved by the cardholder, reducing the balance of available funds until the merchant clears the transaction (also called settlement), after the transaction is completed or aborted, or because the hold expires.
In July the Pre-Existing Condition Insurance Plan (PCIP) took effect to offer insurance to those who had been denied coverage by private insurance companies because of a pre-existing conditions. Despite estimates of up to 700,000 enrollees, at a cost of approximately $13,000/enrollee, only 56,257 enrolled at a $28,994 cost per enrollee.
Security Assertion Markup Language 2.0 (SAML 2.0) is a version of the SAML standard for exchanging authentication and authorization identities between security domains.SAML 2.0 is an XML-based protocol that uses security tokens containing assertions to pass information about a principal (usually an end user) between a SAML authority, named an Identity Provider, and a SAML consumer, named a ...
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2]
CVS Pharmacy Inc. is an American retail corporation. A subsidiary of CVS Health, it is headquartered in Woonsocket, Rhode Island. [6] Originally named the Consumer Value Stores, it was founded in Lowell, Massachusetts, in 1963.
A change-advisory board (CAB) delivers support to a change-management team by advising on requested changes, assisting in the assessment and prioritization of changes. This body is generally made up of IT and Business representatives that include: a change manager, user managers and groups, product owners, technical experts, and possible third parties and customers (if required).