Off late, we have seen many patient's finding it difficult to fill prescriptions. The problem is created by middlemen.
Here is how to deal with prescription denials from your insurance.
- Call the insurance and ask them to provide you a PDL (Preferred Drug List); All the drugs are classified into various classes. If we have PDL from your insurance we may be able to change the prescription to what is covered by your insurance. Always carry soft copy of your PDL with you on your phone and provide a copy to us so that we can put that in your chart.
- Check the price of the medicine at goodrx.com and you may find some coupons that can work with your insurance.
- Use Blink Health App to pay for the medicines without insurance. Most of the times you find that cash price is lower than insurance copay.
- If the cost is too prohibitive we will offer prior authorization for the medicine, if you are able to provide us correct form from the insurance. Please drop the form to our front office after filling all the patient relevant details. We will fill the physician side of the form and fax it with medical justification. Getting a form is preferred option. We do not charge for filling forms and sending medical justification on fax.
- If insurance wants to talk to the doctor, book an appointment with the doctor and call your insurance from our office during that appointment. You can even book an eVisit for this. Tell your insurance that doctor has agreed to work for free if insurance gives the form to you so tell them to work with forms, rather than phone calls.