- is a way to keep HealthCare cost in check. It will make sure that the service or drug that the physician is requesting is truly medically necessary.
- it will also ensure that the service isn't being duplicate.
 
PA CRITERIA
EXCULUSION - state if the drug must or must not be used with other medications.
REQUIRED MEDICAL INFORMATION - Documentation like diagnosis or test results needed for coverage.
AGE RESTRICTIONS - Limits or allows use based on the patient's age.
PRESCIBER RESTRICTIONS - Requires the drug to be prescribed by a specialist.