Hello Reddit!
Here is my situation. About 9 months ago I went to a dermatologist with my mother and we both got special compound medication prescribed. At the pharmacy they ran it through insurance and got rejected. Back then I didn’t know of the pre-authorization process so we paid cash. We refilled it multiple times and it all came out to $1200.
Months after I realized I can go back and file reimbursement. I did it for both of us and got $200 back but there is still $ on the table, most likely $500-$700.
I was told I need to go through the pre authorization process which I did, and it took great effort making my doctor do this. It seems as tough the nurses in the doctors office are very unpleased to do this – as I am assuming they don’t want their time to be taken by this since they already made their money and are looking to get new patients to make more money since they are a private clinic. I was also told and experienced this in person that this doctor comes in, looks at you for 2 min, prescribes you the drugs, and keeps moving on to the next patient, as the more patients he sees the more he makes.
Anyways, the pre authorization got denied partly because the doctor office didn’t respond to a fax of additional information that was sent over to them. So I called insurance got doctor office on the line and they said they will fax them the docs for an appeal.
This seems very time consuming and energy wasted, as I have to keep checking on my doctors office if they are doing the work and have to go through all this process to have MedImpact insurance approve these drugs as they are giving me a hard time since I am guessing they would obviously like to keep more $ in their pocket.
Would love to hear any thoughts on how I can go about this!
submitted by /u/besmart991
[link] [comments]
Hello Reddit! Here is my situation. About 9 months ago I went to a dermatologist with my mother and we both got special compound medication prescribed. At the pharmacy they ran it through insurance and got rejected. Back then I didn’t know of the pre-authorization process so we paid cash. We refilled it multiple times and it all came out to $1200. Months after I realized I can go back and file reimbursement. I did it for both of us and got $200 back but there is still $ on the table, most likely $500-$700. I was told I need to go through the pre authorization process which I did, and it took great effort making my doctor do this. It seems as tough the nurses in the doctors office are very unpleased to do this – as I am assuming they don’t want their time to be taken by this since they already made their money and are looking to get new patients to make more money since they are a private clinic. I was also told and experienced this in person that this doctor comes in, looks at you for 2 min, prescribes you the drugs, and keeps moving on to the next patient, as the more patients he sees the more he makes. Anyways, the pre authorization got denied partly because the doctor office didn’t respond to a fax of additional information that was sent over to them. So I called insurance got doctor office on the line and they said they will fax them the docs for an appeal. This seems very time consuming and energy wasted, as I have to keep checking on my doctors office if they are doing the work and have to go through all this process to have MedImpact insurance approve these drugs as they are giving me a hard time since I am guessing they would obviously like to keep more $ in their pocket. Would love to hear any thoughts on how I can go about this!
submitted by /u/besmart991 [link] [comments]Read Morer/HealthInsurance