A proactive medical necessity review program reduces revenue loss associated with outpatient medical benefit drugs.

Purpose A common denial trend that occurs with "outpatient medical benefit drugs" (ie, medications covered by a medical benefit plan and administered in an outpatient visit) is payers not requiring or permitting prior authorization (PA) proactively, yet denying the drug after administration for medi...

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Detalles Bibliográficos
Publicado en:American Journal of Health-System Pharmacy Vol. 78; no. 17; pp. 1591 - 1600
Autores principales: Hawes, Emily M, Misita, Caron P, Amerine, Lindsey B, Francart, Suzanne J
Formato: algorithm tables/charts Journal Article
Publicado: Oxford University Press / USA Sep2021
Acceso en línea:Ver este registro en EBSCOhost