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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.
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 ...
Prescription drug plans are a form of insurance offered through some health insurance plans. In the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan. [5]: TS 2:21 Such plans are routinely part of national health insurance programs. For ...
About 35,000 Providence patients with Aetna insurance plans could lose coverage starting this weekend if the two don’t agree on a new contract soon, the Renton-based health care system said ...
Aetna offers three different Medicare Part D plans, with offerings available across the United States. Find out what these plans cover and how much they may cost. What Aetna Medicare Part D Plans ...
Healthcare in the United States Government health programs Federal Employees Health Benefits Program (FEHBP) Indian Health Service (IHS) Medicaid / State Health Insurance Assistance Program (SHIP) Medicare Prescription Assistance (SPAP) Military Health System (MHS) / Tricare Children's Health Insurance Program (CHIP) Program of All-Inclusive Care for the Elderly (PACE) Veterans Health ...
Aetna has about 200,000 Medicare Advantage customers in the state. And it has begun to offer plans to nearly 600,000 state employees and teachers for coverage that would go into effect July 1 ...