A "prior authorization" is an extra step that most insurance companies require before they decide if they want to pay for certain medication that may or may not be on their formulary. Some drugs are covered only if your doctor or other network provider gets "prior authorization" from the insurance company.
For drugs that require prior authorization, your doctor must complete the necessary form(s) and include any clinical information and supporting documentation with the form(s). All forms require a physician's signature.
Prior Authorization Services
We ensure patients receive their medications as quickly as possible, while reducing administrative hassles for prescribers. We work with insurance companies directly to reduce “phone tag” between them and prescribers. In addition, we are proactive in communication with patients to keep them up-to-date on approval status.
If patients can’t afford the cost of their medication, even with drug coverage from their insurance company, we can also find out whether they qualify for financial assistance programs from drug manufacturers and non-profits. We will even manage this process while we are seeking approval from their insurance company.