Prior authorization requirement means any practice implemented by either a sickness and accident insurer or a public employee benefit plan in which coverage of a health care service, device, or drug is dependent upon a covered person or a health care practitioner obtaining approval from the insurer or plan prior to the service, device, or drug being performed, received, or prescribed, as applicable. "Prior authorization" includes prospective or utilization review procedures conducted prior to providing a health care service, device, or drug.
Prior authorization requirement means any practice implemented by a health insuring corporation in which coverage of a health care service, device, or drug is dependent upon a covered person or a health care practitioner obtaining approval from the health insuring corporation prior to the service, device, or drug being performed, received, or prescribed, as applicable. "Prior authorization" includes prospective or utilization review procedures conducted prior to providing a health care service, device, or drug.
Prior authorization requirement means any practice implemented by a medical assistance program in which coverage of a health care service, device, or drug is dependent upon a medical assistance recipient or a health care provider, receiving approval from the department of medicaid or its designee, including a medicaid managed care organization, prior to the service, device, or drug being performed, received, or prescribed, as applicable. "Prior authorization" includes prospective or utilization review procedures conducted prior to providing a health care service, device, or drug.
Examples of Prior authorization requirement in a sentence
Prior authorization requirement for an initial length of stay will be established by the Department, or its designee, in the Idaho Medicaid Provider Handbook.
Explain why the drug or item is not covered and suggest alternatives to the member, caregiver, or practitioner.♦ Prior authorization requirement.
Prior authorization requirement" has the same meaning as in section 5160.34 of the Revised Code.
Prior authorization requirement" has the same meaning as in section 5160.34 of theRevised Code.
Explain why the drug or item is not covered and suggest alternatives to the member, caregiver, or practitioner.▪ Prior authorization requirement.
More Definitions of Prior authorization requirement
Prior authorization requirement means any practice implemented by a health plan issuer in which coverage of a health care service, device, or drug is dependent upon a covered person or a health care practitioner obtaining approval from the health plan issuer prior to the service, device, or drug being performed, received, or prescribed, as applicable. "Prior authorization" includes prospective or utilization review procedures conducted prior to providing a health care service, device, or drug.
Prior authorization requirement means any practice 69
Prior authorization requirement means a practice implemented by a health care services plan or its utilization review agent in which coverage of a health care service is dependent on an enrollee or a provider obtaining approval from the health care services plan before the service is performed, received or prescribed, as applicable. Prior authorization review includes preadmission review, pretreatment review, prospective review or utilization review procedures conducted by a health care services plan or its utilization review agent before providing a health care service, but it excludes case management or step therapy protocols.
Prior authorization requirement means any practice implemented by a health insuring corporation in which coverage of a health care service, device, or drug is dependent upon a covered person or a health care practitioner obtaining approval from the health insuring corporation prior to
Prior authorization requirement means any practice in which coverage of a health care service, device, or drug is dependent on a medicaid recipient or medicaid provider obtaining approval from the medicaid program prior to the service, device, or drug being performed, received, or prescribed. "Prior authorization" includes prospective or utilization review procedures conducted prior to a health care service, device, or drug being provided.
Prior authorization requirement means any practice implemented by a health plan issuer in which coverage of a health care service, device, or drug is dependent upon a covered person or a health care practitioner obtaining approval from the health
Prior authorization requirement means any practice 39