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Overview. Prior authorization is a check run by some insurance companies or third-party payers in the United States before they will agree to cover certain prescribed medications or medical procedures. [1] There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a ...
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American ...
Humana. Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. In 2023, the company ranked 42 on the Fortune 500 list, [ 2] which made it the highest ranked (by revenues) company based in Kentucky. It is the fourth largest health insurance provider in the U.S. [ 3]
Medicare Advantage ( Medicare Part C, MA) is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). Under Part C, Medicare pays a sponsor a fixed payment. The sponsor then pays for the health care expenses of enrollees.
All right, for more on a rough day for the markets. A slew of weaker-than-expected economic data, highlighted by July's jobs report triggering a closely watched recession indicator, has sent the ...
Humana reported the preliminary 2023 fourth quarter numbers — 91.4% medical loss ratio, compared to an 89.5% expected — ahead of its fourth quarter earnings on Jan. 25.
The Cigna Group is an American multinational managed healthcare and insurance company based in Bloomfield, Connecticut. [2] [3] Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups (e.g., governmental and non-governmental organizations ...
Specialty drugs or specialty pharmaceuticals are a recent designation of pharmaceuticals [ 1][ 2] classified as high-cost, [ 3][ 4][ 5] high complexity and/or high touch. [ 4] Specialty drugs are often biologics [ 3][ 6] —"drugs derived from living cells" [ 7] that are injectable or infused (although some are oral medications). [ 4]