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Tag: medical and pharma prior auth

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October 26, 2023

Navigate the Medical vs. Pharma Prior Authorization Maze More Easily with Prior Authorization Software As Your Guide

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

Dealing with prior authorizations compares to navigating a labyrinth—complex, frustrating, and time-consuming. Created to ensure the optimal use of healthcare resources and minimize unnecessary expenses, these authorizations come in two flavors: medical and pharma. What differentiates the two, and why should you care? As the regulatory landscape around interoperability, prior authorizations, and pharmacy benefit managers (PBMs) continues to evolve,  integrated prior authorization software offers a robust solution now and into the future.  What distinguishes medical prior auth from pharma prior auth?  Medical prior authorizations pertain to the pre-approval necessary for various healthcare services like surgeries, diagnostic tests, or medical equipment.… Read entire article here

October 9, 2023

Ensuring Reimbursement Success: 6 Prior Authorization Tips for Oncology Providers

by Susan Lawson-Dawson | Healthcare Technology, Prior Authorization

In the ever-evolving realm of healthcare, oncology stands out as a field that requires prompt, precise, and above all, compassionate care. Every procedure, medication, or therapeutic session can be pivotal in a patient's battle against cancer. And herein lies the challenge: How do you ensure that potentially life-altering treatments earn prompt approval, reducing gaps in patients’ care journeys and in your revenue cycle simultaneously?  Addressing process inefficiencies with prior authorization automation makes a huge difference. After all, prior authorization doesn’t just result in an approval or denial for patient care. It also confirms a payer’s commitment to reimburse you for… Read entire article here