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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 ...
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.
Humana Inc. Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. In 2023, the company ranked 42 on the Fortune 500 list, [2] which made it the highest ranked (by revenues) company based in Kentucky. It is the fourth largest health insurance provider in the U.S. [3]
Humana (HUM) stock tumbled more than 12% on Thursday after the US health insurer reported an increase in older patients seeking care, which would hurt its fourth quarter results.
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. [1] [2] Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing ...
Specialty drugs in the United States. Specialty drugs or specialty pharmaceuticals are a recent designation of pharmaceuticals [1] [2] classified as high-cost, [3] [4] [5] high complexity and/or high touch. [4] Specialty drugs are often biologics [3] [6] —"drugs derived from living cells" [7] that are injectable or infused (although some are ...
Los Angeles has a number of candidates it is interested in, and there are a few factors guiding the hiring process.
After an individual requests information in writing (typically using the provider's form for this purpose), a provider has up to 30 days to provide a copy of the information to the individual. An individual may request the information in electronic form or hard-copy, and the provider is obligated to attempt to conform to the requested format.
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