Search results
Results from the WOW.Com Content Network
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
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.
Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Aetna is one of the nation's leading diversified health care benefits companies, serving approximately 37.3 million people with information and resources to help them make better informed ...
Aetna began life in Hartford, CT, in 1853. They are now part of the CVS Health group. The company estimate that 39 million people rely on them for healthcare, and the Aetna network includes 1.2 ...
The potential move to out-of-network — which would increase what Aetna customers pay for health care at more than 19 NewYork-Presbyterian sites across the New York City metro region, or force ...
In 1820, there were 17 stock life insurance companies in the state of New York, many of which would subsequently fail. Between 1870 and 1872, 33 US life insurance companies failed, in part fueled by bad practices and incidents such as the Great Chicago Fire of 1871. 3,800 property-liability and 2,270 life insurance companies were operating in ...
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4]