Reply to Can someone help with this doctor and prior authorization snafu?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]If you are able, I’d suggest researching the criteria to get the medicine in the first place, and also to continue it, and then write up an appeal on your own. You can probably find samples online. You might want to request supporting records from the physicians’ offices to support the appeal. Them take the whole thing, with a pen, along with a draft on a new flash drive, make an appointment, and give it to the doctor to sign and submit.

If that doesn’t work you need a significantly better doctor. [/quote]

I meet the criteria. I have called, and checked. The doctor "does not do appeals.'

Finding a new PCP might take months. I might try Midi, but I don't know if insurance will let me start all over. [/quote]

It will, so you should start the process of switching doctors now.[/quote]

And, how do I find a doctor who will do appeals? Is it a new Rx with a new doctor or an appeal? All of these questions are exhausting me.[/quote]

From what you've described, you don't have an appealable issue. Your doctor never submitted correct paperwork.

But an office that refuses to do appeals should be a red flag. You'll have to call up difference offices and ask them.[/quote]

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