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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.
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.
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.
Aetna, Humana, Anthem and Cigna cited the Affordable Care Act, popularly known as Obamacare, which was passed by Congress in 2010 to significantly expand access to affordable health insurance.
The individual insured person's obligations may take several forms: [citation needed] Premium: The amount the policy-holder or their sponsor (e.g. an employer) pays to the health plan to purchase health coverage. (US specific) According to the healthcare law, a premium is calculated using 5 specific factors regarding the insured person.
During his tenure, Aetna was named Fortune magazine's most admired Company in the Health Care: Insurance and Managed Care category for three consecutive years. [12] In 2011, Aetna's revenues were $34 billion, and the firm ranked 77th on the Fortune 100 list. Mr. Williams joined Aetna in 2001 and in 2002 was named president and joined Aetna's board.
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