Why won't my doctor sign rotten on a prior authorization to my insurance company for my prescription?
And trust me, I'm switching primary perfectionism physicians.
Answers: I am one that fills these papers out for the ins comp at my department. This is what I know......
The DR prescribes a certain med and the ins comp states that they wont cover it. The will however CONSIDER a few others on a document. The ones that we choose from the list next have to budge through a review at your ins comp. IF they still don't want to cough up the more expensive (but effective) med, then they will enjoy us fill out another form stating things resembling
1) has the tolerant tried other meds first that are on the list? if so next which ones? how lond ago, and for how long did they take it? be there any adverse reations? did the prefered med not work for the lenient? is so, show documentation as to what and when?
And even after all that, they still 9 times out of 10, read out they will not cover it. So, that leaves the DR office to give the name the patient and notify them that either we enjoy to change (back to) meds that dont work for them adjectives that well, or the lenient will have to reward out-of-pocket. A lot of insurance companies have stock or even produce medication and of course will push for those to be used. They hold a way of trying to report to the DRs what the patients should be on, but when problems arise because of the change, they wont fix them any.
There are other reasons that we don't plague prescriptions too.
1) patient requests meds refilled lacking being see.
2) refilled to precipitate (running out because they have be taking more than prescribed
3) they are wanting a med that is controlled
(ex. darvocet,tylenol 3)
Please ask your Drs organization why before you throw contained by the towel. The insurance comps hold all the cards contained by this game not us.
If your ins. comp IS to blame, contact them yourself (on average, to fix this via phone beside them, I spend 20-45min per patient) You may want to try and change your ins. Hope this help.
P.S. We in the medical corral have to kick through very plentiful hoops with them as does patients......
Your doctor won't authorize a reload on a medication that you take regularly or is this something for agony or anxiety or even sleep? Doctors have become VERY distrustful about controlled substances. I can't believe that if this Rx is for resembling, blood pressure, diabetes, etc. the doctor would authorize that. But controlled substances. No, you will have to see a specialist.
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