This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
UnitedHealth Group, the largest health care company in the U.S., The sprawling conglomerate — which owns a major healthinsurancecompany, physician practices, a pharmacy benefit manager, and numerous other firms — acquired or created more than 250 subsidiaries in 2024.
The nation’s largest healthinsurancecompany pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found.
For more than a year, our reporters have documented how the use of artificial intelligence is driving denial of claims or delaying treatment for seriously ill patients. This latest story goes even deeper, establishing how the denial of claims was by design.
The federal government and healthinsurancecompanies have been clashing for more than a decade over how Medicare Advantage plans should be audited and how the well-documented overpayments to those plans should be clawed back.
This document is where the government has in the past rolled out changes to the so-called hospital price transparency rule, but the Biden administration did not address the issue in this edition. Since 2021, hospitals have been required to post the prices they have negotiated with all healthinsurancecompanies, as well as their cash prices.
While SaveOnSP is the nominal target of the lawsuit, it claims to expose one of the failings in the US healthinsurance sector, adding fire to an increasingly heated exchange between pharma manufacturers and pharmacy benefit managers (PBMs), which have blamed each other for high medicine prices in the US.
Step therapy focuses on using cost-effective treatments for various conditions, which may help save money in the long run for insurancecompanies and the people they cover. Step therapy is a process used by healthinsurancecompanies to manage and control prescription drug costs. What is step therapy?
Adults, adolescents, and children 10 years and older Adults, adolescents, and children 7 years and older Latuda vs. lithium: Conditions treated Through rigorous clinical trials and documentation, the FDA approves medications for very specific uses. However, drug costs vary depending on your insurance plan and pharmacy used.
With insurance coverage, your health plan will have a provider network of in-network providers and hospitals they contract with to provide care to you and other members. You can contact your healthinsurancecompany for assistance in choosing a provider in your network.
The largest non-profit provider of behavioral healthcare in California used Salesforce Nonprofit Cloud to meet the increasing demand for mental health services and automate their workflow. Humana , a US-based healthinsurancecompany, took advantage of a few Salesforce products at once to build a single view around their customers.
Prior authorization is a common part of the process of receiving coverage for a prescription drug through your insurance provider. All insurancecompanies have their own set of criteria that determine which drugs they cover and at what cost to the patient.
Aripiprazole is typically covered by insurance and Medicare Part D, but coverage varies by plan. Confirm aripiprazole insurance coverage by viewing the plans formulary. Many insurancecompanies provide a copy of this document online, but customer service can also mail a printed version upon request.
According to Novo Nordisk , the drugs manufacturer, roughly 98% of commercial insurance recipients and 95% of Medicare Part D recipients receive coverage for Rybelsus. In addition to prior authorization, Dr. Pasquale says an insurancecompany may require step therapy before paying for Rybelsus.
We organize all of the trending information in your field so you don't have to. Join 5,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content