Priorauthtraining.org

Prior Authorization Training – National Board of Prior …

WEBThe Prior Authorization Certified Specialist (PACS) graduates are expanding patient access, advocating for better patient outcomes, and leading the reimbursement and access …

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URL: https://www.priorauthtraining.org/

Utilization Management: Here’s What You Need to Know

WEBA growing number of complex, expensive medications are entering the market. At the same time, health insurance companies, also called payer, are increasingly relying on …

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The Definitive Guide to Prior Authorization

WEBKey Takeaway. Prior Authorization (PA) allows your health insurance company a chance to review how necessary a certain medication may be in treating your medical condition. …

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What is Prior Authorization

WEBBy Amanda DeMarzo , December 15, 2020. Prior authorization (prior auth, or PA) is a management process used by insurance companies to determine if a prescribed product …

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Roles Involved in Prior Auths: Responsibilities & Education

WEBPrior Authorization Coordinator (PAC): PACs verify/review the information received, communicate with the patient’s provider/pharmacy if additional information is needed, …

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What-is-PACS – Prior Authorization Training

WEBWhat is PACS™? The Prior Authorization Certified Specialist (PACS) program is the only program focused on the information necessary to be a successful access and …

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pacs-ads-landing-page – Prior Authorization Training

WEBThe Prior Authorization Certified Specialist (PACS) program is the only program focused on the information necessary to be a successful access and reimbursement professional. …

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The Impact of Prior Authorization on Patient Compliance and …

WEBPrior authorization can increase prescription abandonment by nearly 40%, and prescription abandonment increases the risk of adverse event problems or hospitalization. …

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The Evolution of Prior Authorizations – Prior Authorization Training

WEBPrior authorizations actually originated from the use of utilization reviews in the 1960s. Utilization reviews started at the beginning of Medicare and Medicaid legislation. Their …

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What is Managed Care

WEBBy Amanda DeMarzo , December 29, 2020. Managed care is a method of optimizing patient health using evidence-based healthcare strategies and resources. The purpose of …

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What is a Managed Care Pharmacist

WEBManaged care is a method for optimizing patient health using evidence-based medication strategies. The purpose is to enhance the quality of healthcare for all patient populations …

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What is Buy and Bill

WEBThis process is called buy-and-bill. Buy-and-bill is a process where physician offices receive medications for in-office administration. Providers order the medication (the “buy” part) …

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Importance of the HIPAA Security Rule – Prior Authorization Training

WEBIn order to help combat potential security risks, the HIPAA Security Rule was created under the Health Insurance Portability and Accountability Act of 1996. This law required the …

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An Essential Guide to Step Therapy – Prior Authorization Training

WEBPrior authorization (prior auth or PA) is also a managed care process designed to reduce healthcare costs. PAs require patients to obtain approval from the payer before …

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Overview of the Prior Authorization Certified Specialist Program

WEBExploring the buy-and-bill process in healthcare, this blog post delves into its advantages, challenges, and best practices for…

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A Look into Peer to Peer – Prior Authorization Training

WEBPeer to Peer (or P2P) is essentially the patient’s doctor justifying a patient’s medical order, prescription, or inpatient status to the insurance company’s medical director. These …

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5 Tips to Become a Field Reimbursement Manager

WEBdrug price tiering. 2. Cultivate soft skills. Aside from the knowledge and expertise required for the FRM’s role, soft skills are also essential, including: working as a “team player” …

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What are Copay Maximizers and Accumulators

WEBCompanies implement these programs to spread out cost-savings for patients over a longer period of time. This leads to the drug manufacturers mitigating cost-sharing burden. …

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What is an Insurance Exclusion List

WEBA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. It is also called a drug list. Each …

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