The study authors reported that plans in the South had the highest rates of exclusive PAs for either emtricitabine/tenofovir disoproxil fumarate or emtricitabine/tenofovir alafenamide even if the plan covered both, from 2018 to 2020. High rates of prior authorizations (PAs) could prevent HIV pre...
In one specific case, 81% of the reimbursed cost for a patient visit was consumed by seeking a prior authorization. Prior authorizations nearly doubled over 2 years at one center In 2015, I wrote a column, "Prior authorization for medications: Who oversees placement of the hoops?" The arti...
Leveraged HL7®FHIR interoperability standards to automate bidirectional data exchange for prior authorizations:TheHL7®Da Vinci Projectis a national private and public sector initiative to accelerate the use of HL7®FHIR to enable data sharing that adva...
has 16,800 employees in its hospitals, multispecialty physician groups, and associated health care businesses. Common frustrations included navigating payer requirements, submitting authorizations, and tracking approvals. These administrative burdens, while crucial, were draining valuable time and resources fr...
During an interview withPharmaNewsIntelligence, Lauren Fredin and Brian Arendt, Product Directors at Optum, discussed an innovative solution that is reshaping the healthcare industry, allowing providers to achieve over 60% auto-approval for specialty and oncology prior authorizations within 10 m...
we design programs to help keep prescription drug coverage affordable. Prior authorization is the process of obtaining coverage approval for a medical or behavioral health service or procedure in advance of treatment. Learn more about electronic authorization. . Anthem Blue Cross and Blue Shield is th...
22-24 However, questions remain about whether there was an increase in buprenorphine-involved overdose deaths following implementation of these new emergency authorizations that removed historical measures intended to reduce diversion and misuse of buprenorphine. This study assessed trends in buprenorphine-...