by Hargun Ghai | Jan 23, 2025 | Electronic Prior Authorization, Prior Authorization
One of the most common and often misunderstood components of insurance plans is prior authorization (PA). While it might seem like an extra hurdle, PA plays a significant role in healthcare cost management and patient safety. What is Prior Authorization? Prior...
by Hargun Ghai | Jan 8, 2025 | CMS, Medication Therapy Management
The Centers for Medicare & Medicaid Services (CMS) recently released updated guidelines for the Medication Therapy Management (MTM) program, effective January 1, 2025. These changes significantly impact how health plans and PBMs can participate and deliver...
