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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 ...
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.
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Americans made $3.6 billion in charitable donations this week — a double-digit increase of 16% from Giving Tuesday 2023’s total of $3.1 billion, according to The GivingTuesday Data Commons ...
As of 2017, the largest commercial plans were Aetna, Anthem, Cigna, Health Care Service Corp, UnitedHealthcare, and Centene Corporation. [27] As of 2017, there were 907 health insurance companies in the United States, [28] although the top 10 account for about 53% of revenue and the top 100 account for 95% of revenue. [29]: 70
After deputies arrested the child's father at the family's home, he reportedly agreed to speak with officers and, according to the complaint, said he used "a utility tool" for the procedure.
Mark T. Bertolini (born 1956) is an American businessman who is currently the CEO of Oscar Health, a tech-driven health insurance company located in New York.He was the co-CEO of Bridgewater Associates, one of the world's largest hedge funds, and was previously the CEO of Aetna, a Fortune 50 diversified health care benefits company with over $60 billion in 2015 revenue.
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