prior authorization


Also found in: Acronyms.

prior authorization

Health insurance A cost containment measure that provides full payment of health benefits only if the hospitalization or medical treatment has been approved in advance

prior authorization

The approval by an insurer or other third-party payor of a health care service before the service is rendered. This approval is required in order for the insurer to pay the provider for the service.

prior authorization,

References in periodicals archive ?
As the leading cloud-based EHR on the market, Practice Fusion's integration with CoverMyMeds is an important step in fueling ePA adoption and making electronic prior authorization more accessible to prescribers," said Matt Scantland, Co-Founder of CoverMyMeds.
First and foremost, minimize the wasted time prior authorizations cause you and your staff.
Physicians might experience some relief in terms of prior authorization and exceptions if their patients haven't changed drug plans, Dr.
They don't have to hassle with prior authorizations for medications, and they don't have people calling saying, 'This drug isn't covered; can you write something else?
Electronic Prior Authorizations: NaviNet Mobile Connect for PBMs automatically alerts physicians when a prior authorization is needed, initiates the process and sends documentation to physician office staff for completion.
Our comprehensive suite of PA solutions combine state-of-the-art information technology systems with experienced and service-focused operations to promote compliance monitoring, adherence, and criteria management for greater administrative control of prior authorization programs.
The bottom line is that busy physicians don't have time to battle the prior authorization process.
With these announcements, Silver-Script, a subsidiary of Caremark, becomes the only one of the nine national or near-national Part D drug plan sponsors that still requires prior authorization, according to the Alzheimer's Association.
CareCore's prior authorization methodology provides a way to ensure the patient is an appropriate candidate for ICD implantation prior to the device being implanted, which leads to the best possible patient outcomes.
We have made it possible for our Claim and Prior Authorization systems to 'talk' to each other in order to improve service for physicians.
Using the integrated functionality, pharmacies can automate the selection and completion of the appropriate prior authorization form, saving an exorbitant amount of time searching for the appropriate and most current insurance form.
Two major Medicare Part D drug plans recently stopped requiring prior authorization for coverage of Alzheimer's medications, according to officials at the Alzheimer's Association.