Prior Authorization Requests
- Prior authorisations are required when your insurance company requires justification for why you need to take this medication.
- Completing a request does not guarantee your insurance company will agree to pay for the medication. I will do my best to advocate for you. Should they deny coverage, your options then would be to pay out of pocket or change medications.
- I will need up to date insurance information (including any of the following if you see it on your card: Plan Name/BIN/PCN/Rx Group). This will help ensure the correct form for your specific insurance is completed. If the wrong form is used, the PA would need to be redone and would delay a response.
- Insurance companies generally have 5-7 days to reply.
- I may need to correspond with you for information regarding previous trials of medications if the insurance company requires.
- Please do not text me to let me know you have a prior authorisation request.
- If you do not want to wait for a response from your insurance company, you can fill it out of pocket. Some insurances will retroactively reimburse you once a PA is completed. There is an app called GoodRx that will provide coupons to help offset the price.