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A prior authorization request, for instance, may have included 10 therapy sessions, but only five were approved, the researchers found. Still, “people who go through that appeals process are ...
Kaiser Permanente is a large integrated managed care organization that operates in eight states and the District of Columbia. It consists of three groups of entities: health plans, hospitals, and medical groups, with a history of quality care, controversies, and governance.
Managed care is a system of delivering and receiving health care in the U.S. that aims to reduce costs and improve quality. It involves various mechanisms, such as provider networks, utilization review, and cost-sharing, and has a controversial impact on health care access and outcomes.
Protected health information (PHI) is any information about health status, provision of health care, or payment for health care that is linked to a specific individual. Learn about the types, purposes, and regulations of PHI under U.S. law, and the difference between de-identification and anonymization.
Prior authorization is a process used by some health insurance companies in the US to determine if they will cover a prescribed procedure, service, or medication. It involves completing and faxing a form, and may result in approval, denial, or step therapy.
A large Kaiser Permanente medical facility and 420-bed hospital in Fontana, California, serving over 400,000 members. Learn about its history, services, programs, and new construction project.
A hospital in Hillsboro, Oregon, opened in 2013 by Kaiser Permanente. Learn about its history, design, services, and expansion plans.
A Kaiser Permanente hospital in South San Jose, ranked among the top 50 best hospitals in the US by Healthgrades. It offers medical services, training, and a farmers market, and faced a large COVID-19 outbreak in 2020.
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