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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.

  3. 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 ...

  4. 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 ...

  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 to control the costs and risks posed by prescription drugs.

  6. Unhappy with your Medicare Advantage plan? There's time to ...

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    To push back on Medicare Advantage plans that make serious usage of prior authorization before approving care, the Department of Health and Human Services announced new rules that will require ...

  7. Electronic prescribing - Wikipedia

    en.wikipedia.org/wiki/Electronic_prescribing

    Electronic prescriptions were introduced in Estonia in January 2010 [27] and by mid-2013, 95% of all prescriptions in the country were being issued electronically. [28] e-Prescription, is a centralized paperless system for issuing and handling medical prescriptions. When a doctor prescribes medicine using the system, he or she does so ...

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