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Prior authorization, or preauthorization, [1] is a utilization management process used by some health insurance companies in the United States to determine if they ...
Insurance companies determine what drugs are covered based on price, availability, and therapeutic equivalents. The list of drugs that an insurance program agrees to cover is called a formulary. [7] Additionally, some prescriptions drugs may require a prior authorization [88] before an insurance program agrees to cover its cost.
Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing.
A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. [1] Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication (a resource closer to what would be referred to as a pharmacopoeia ...
Providing information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's insurance provider; System integration capabilities (e.g., connection with various databases, connection with pharmacy and pharmacy benefit manager systems)
(Reuters) -Monday's ruling from the Texas Supreme Court denying a woman's request for an emergency abortion shines a spotlight on the medical exceptions contained in many U.S. states' abortion bans.
Investigators believe the child was exposed to “elevated temperatures” prior to his death, per the statement. They said the child had been left isolated in a room with a space heater for more ...
Step therapy, also called step protocol or a fail first requirement, is a managed care approach to prescription.It is a type of prior authorization requirement that is intended to control the costs and risks posed by prescription drugs.