%0 Journal Article
%T Prior Authorization for Elective Diagnostic Catheterization: The Value of Reviewers in Cases with Clinical Ambiguity
%A Adam C. Powell
%A Gary L. Smith
%A James W. Long
%A Khoa Nguyen
%A Stephen E. Price
%A Uday U. Deshmukh
%J Archive of "American Health & Drug Benefits".
%D 2018
%X In many situations, evidence-based guidelines cannot provide definitive guidance on the appropriateness of diagnostic catheterization. One specialty benefit management company has taken a 2-step approach to address this ambiguity by evaluating the appropriateness of diagnostic catheterization orders using a rule-based decision support system, and then having reviewers provide input through the consult system of a nondenial prior authorization program that involves peer discussion
%K cardiac catheterization
%K decision support systems
%K prior authorization
%K rule systems
%K specialty benefit management
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207309/