AETNA FORWARD PROGRAM

Owner

Goods & Services

Business administration of patient insurance reimbursement programs; Health care utilization and review services, namely, verification of health benefits, prior authorization and health care review services; Administering healthcare management programs, namely, cost management and consultation for the healthcare and prescription drug benefit plans of others

Insurance administration and underwriting of medical, hospital and related health care services and benefit programs that do not require prior authorizations; Insurance services in the form of insurance verification services, namely, verifying Medicaid, Medicare, and commercial insurance eligibility status and related information for others; Providing insurance and insurance reimbursement information; Insurance and financial services pertaining to submission of medical claims, and handling of assignment of benefits, namely, medical insurance claims administrative services, financial administration of medical and pharmaceutical reimbursement collection for patients from private and public sources, financial administration of pharmaceutical reimbursement collection programs for others, administration of employee pharmaceutical benefits concerning insurance and finance; Claims processing of pharmaceutical insurance benefits, namely, processing and administering individual prescription claims history, benefit amounts, accumulations for deductibles and out-of-pocket expenses and expense summaries; Healthcare benefit management services, namely, insurance claims processing for healthcare benefits in the nature of verification and processing of consumer healthcare benefits and prior authorization requests