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A number of legislative and technological developments attempt to optimize the prior authorization process: [16] In 2011, the American Medical Association recommended a uniform prior authorization form with real-time electronic processing. The proposed process would involve a physician ordering a medical service, their staff completing a ...
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4]
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.
Aetna, Riverside Health System Form Accountable Care Organization, Introduce New Products NEWPORT NEWS, Va.--(BUSINESS WIRE)-- Aetna (NYSE: AET) today announced an accountable care organization ...
The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.
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.
In October 2000, the company acquired WellPath, the managed care subsidiary of Duke University Health System, for $20.7 million. [ 4 ] In October 2010, the company acquired MHP (Mercy Health Plans), an insurer with approximately 180,000 members in Missouri and northwest Arkansas.
The Express Scripts acquisition would be the last major deal involving the country's largest PBMs. In 2017, CVS Health announced a merger with Aetna, completing in November 2018. [38] The takeover of PBMs have drawn regulator resistance because of fears they foster an anti-competitive environment.