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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.
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 ...
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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The company was founded in 1986 in Nashville by Phil Bredesen. [3]In August 1998, the company merged with Principal Health Care and moved its headquarters to Bethesda, Maryland.
In 1951, Aetna developed the Aetna Drivotrainer, the first combination of automobile simulator and motion pictures designed for behind-the-wheel instruction in drivers' training classrooms. The Drivotrainer classroom contained 15 small single seat "Aetnacars" equipped with controls as similar as possible to those used in actual automobiles.
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SAN FRANCISCO--(BUSINESS WIRE)-- Aetna (NYSE: AET) and Brown & Toland Physicians (BTP) today announced a new accountable care organization (ACO) model of health care that is designed to improve ...