Topic 4: Roles of pharmaceutical companies and insurance providers.
- Detailed Content: Insurance companies influence medication management through their coverage policies, which can affect patient access to certain medications.
- Scenario-Based Example: A healthcare provider navigating insurance coverage to ensure a patient receives the necessary medication under their health plan.
- Terminology:
- Insurance Coverage for Medication: Policies determining which medications are covered under health insurance plans.
- Prior Authorization: The process of obtaining insurance approval before administering certain medications.
- Coverage Denial Management: Handling cases where a patient’s medication is not covered by insurance.
- Patient Advocacy in Insurance: Acting on behalf of patients to secure medication coverage.
