Step therapy means a protocol or
Step therapy means a protocol by a healthcare insurer
Step therapy means a process that establishes a required order of use for a specific Prescription Medication. For example, a Step Therapy may require that medication “X” be used for a period of time before medication “Y” or that a weaker strength of a medication be used for a period before a stronger strength of the same medication.
Examples of Step therapy in a sentence
Step therapy exceptions are also subject to the Prior Authorization process.
Step therapy determines the specific usage progression of therapeutically equivalent drug products or supplies appropriate for treatment of a specific condition.
Step therapy protocols are bypassed for MIC drugs and these claims are paid outside of TF.
TF eligible Step therapy, Prior Authorization and non-safety quantity limit edits are resolved at POS.
Drug Products subject to PA may require confirmation of diagnosis or submissionof laboratory and other supporting information.Step therapy (ST) Step therapy promotes the use of one or more alternatives which are safe and cost-effective prior to receiving approval for the requested Drug Product.
More Definitions of Step therapy
Step therapy is a program for Members who take Prescription Drugs for an ongoing medical condition, such as arthritis, asthma or high blood pressure, which ensures the Member receives the most appropriate and cost-effective drug therapy for their condition. The Step Therapy program requires that before benefits are payable for a high cost Covered Drug that may have initially been prescribed, the Member try a lower cost first-step Covered Drug. If the prescribing Physician has documented with HPN why the Member’s condition cannot be stabilized with the first-step Covered Drug, HPN will review a request for Prior Authorization to move the Member to a second-step drug, and so on, until it is determined by HPN that the prescribed Covered Drug is Medically Necessary and eligible for benefit payment.
Step therapy means a program for Insureds who take Prescription Drugs for an ongoing medical condition, such as arthritis, asthma or high blood pressure, which ensures the Insured receives the most appropriate and cost-effective drug therapy for their condition. The Step Therapy program requires that before benefits are payable for a high cost Covered Drug that may have initially been prescribed, the Insured try a lower cost first-step Covered Drug. If the prescribing Physician has documented with SHL why the Insured’s condition cannot be stabilized with the first-step Covered Drug, SHL will review a request for Prior Authorization to move the Insured to a second-step drug, and so on, until it is determined by SHL that the prescribed Covered Drug is Medically Necessary and eligible for benefit payment.
Step therapy means requiring that a lower-cost alternative to
Step therapy means a utilization review protocol, policy or program in which an
Step therapy means a type of protocol that specifies the
Step therapy means a drug protocol in which a health care coverage plan will reimburse the cost of a prescribed drug only if the patient has first tried a specified drug or series of drugs.
Step therapy means a type of protocol that specifies the sequence in which different prescription drugs for a given medical condition and medically appropriate for a particular patient are to be prescribed.