How can I get my prior authorization approved?

How do I obtain a prior authorization?

How to get Prior Authorization (after-the fact):

1. Make sure your doctor has received a call back from the pharmacy.
2. Ask your physician or his staff how long it will take to complete the forms.
3. Contact your insurance company to see if you need to complete any forms.

Who is responsible for authorizing prior authorization? It makes sense that the physician should be responsible for obtaining authorization since they order the procedure for their patient. The doctor has all the information necessary to determine the insurer's eligibility.

It is also important to understand what a prior authorization for a prescribed medication is.

Prior authorization (PA), is the requirement that your doctor obtain approval from your insurance company before prescribing a medication to you. PA is a way to reduce costs. Benefits are only paid if the insurance company has pre-approved the medical care.

Why is authorization necessary?

Prior authorization helps to prevent you from being given medications that you don't need, that may interact with other medications, or that may make you addicted. Your health insurance company can also use prior authorization to help manage the costs of otherwise expensive medications.