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  2. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    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. [5] At this point, the medical service may be approved or rejected, or additional information may be requested.

  3. Step therapy - Wikipedia

    en.wikipedia.org/wiki/Step_therapy

    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 increase insurance company profits at the expense of patient health by forcing patients onto lower cost prescription drugs .

  4. Health First - Wikipedia

    en.wikipedia.org/wiki/Health_First

    Health First logo. Health First is a not-for-profit community health system located in Brevard County, Florida.. Founded in 1995, Health First operates four hospitals—Cape Canaveral Hospital, Holmes Regional Medical Center, Palm Bay Hospital and Viera Hospital—and is home to the county's only Level II Trauma Center.

  5. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]

  6. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    Health Insurance Portability and Accountability Act of 1996; Other short titles: Kassebaum–Kennedy Act, Kennedy–Kassebaum Act: Long title: An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use ...

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    mail.aol.com

    Get AOL Mail for FREE! Manage your email like never before with travel, photo & document views. Personalize your inbox with themes & tabs. You've Got Mail!

  8. Health maintenance organization - Wikipedia

    en.wikipedia.org/wiki/Health_maintenance...

    The earliest form of HMOs can be seen in a number of "prepaid health plans". In 1910, the Western Clinic in Tacoma, Washington offered lumber mill owners and their employees certain medical services from its providers for a premium of $0.50 per member per month. This is considered by some to be the first example of an HMO.

  9. List of healthcare accreditation organizations in the United ...

    en.wikipedia.org/wiki/List_of_healthcare...

    Community Health Accreditation Program(CHAP) DNV GL Healthcare; Foundation for the Accreditation of Cellular Therapy (FACT) [4] Global Healthcare Accreditation (GHA) [5] Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC)

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