Outsource Strategies International (OSI) is experienced in providing pharmacy prior authorization services for all pharmaceutical prescriptions and requests. Our team understands that any delay in prior authorization can also delay patients’ access to treatments and...
Prior authorization -- also referred to as preauthorization, preapproval and precertification -- is a strategy that health insurance companies use to ensure that patients receive treatments and medications that are medically necessary, appropriate, safe, and...
Utilization management (UM) reviews are a component of the value-based care approach. They aim to determine if the care provided to patients is appropriate, efficient, and linked to improved patient outcomes. The UM processes of insurance companies include prior...
Health insurance carriers require prior authorization (PA) as a condition of payment for many services …
Continue reading“Prior Authorizations – Current Challenges and Solutions”
Outsource Strategies International is pleased to announce that BC Advantage Magazine has published their article titled “Pharmacy Prior Authorization – Challenges and Solutions” in ISSUE 15.2., March/April 2020. Pharmacy prior authorization (PA) is the preapproval...
An established medical billing and coding company based in the United States, Outsource Strategies International (OSI) serves diverse medical specialties. In today’s podcast, Natalie Tornese, one of our Senior Solutions Managers, discusses some important points about...
A December 2017 study from the American Medical Association reported that 86 percent of physicians said that prior authorizations have increased during the prior five years, with 51 percent saying that they have increased significantly. The PA process for approval of...
Failure to obtain proper prior authorization is one of the key reasons for claim denials in many medical specialties and radiology is not an exception. Whether you are an imaging specialist or a referring physician, prior authorization from the insurer helps to ensure...
There are many prescriptions that may not be covered by insurers without pre-authorization or prior authorization. To obtain Pharmaceutical prior authorizations it may be necessary to prove that the medication is medically necessary and appropriate for the patient....
Prior authorization is a common strategy that insurance companies use to manage or limit access to certain drugs, treatments, tests, and other medical services. The process requires physicians to obtain pre-approval for procedures or services ordered as part of the...