Hey all! I need some insight into how preauthorizations work. I’m in the dark, which makes me feel “unarmed” on how to proceed here.
My doctor gave me a prescription for Cordran Tape. It’s necessary because I recently had surgery to remove a very large, tumorous, painful, debilitating chest keloid. And it order to keep it from growing back (keloids have a high reoccurence rate), I need Cordran Tape.
I go to CVS to pick up Cordran Tape and the pharmacist tells me that I need preauthorization from my dermatologist before I can get Cordran Tape. I’m not familiar with preauthorization, but she tells me I just need to tell my doctor about it and he’ll get it sorted out.
I email my doctor (it’s the easiest/fastest way to get to him because getting him on the phone is damn-near impossible) and tell him I need preauthorization to get Cordran Tape. He replies and CC’s his assistant to see what I need to make sure I can get the Cordran Tape.
I emailed the dermatologist twice during a span of a week to keep track of what’s going on. Upon the first reply to my email, my dermatologist’s assistant says the preauthorization stuff is “pending.” Upon the second reply, I was told that the preauthorization is denied.
I got a letter in the mail confirming the denial.
So my question is, is there anyway I can appeal this decision? If so, what steps can I take to heighten my chances of getting my Cordran Tape covered? What steps do I even to take (e.g. what Cigna department do I even call? Any tips/suggestions?)
Is it possible that the preauthorization didn’t get accepted because my dermatologist didn’t accurately explain why I’m in desperate need of Cordran Tape? Should I ask my dermatologist to re-appeal or should I do it on my own? Thanks!
submitted by /u/SweetenedCafe
[link] [comments]Hey all! I need some insight into how preauthorizations work. I’m in the dark, which makes me feel “unarmed” on how to proceed here. My doctor gave me a prescription for Cordran Tape. It’s necessary because I recently had surgery to remove a very large, tumorous, painful, debilitating chest keloid. And it order to keep it from growing back (keloids have a high reoccurence rate), I need Cordran Tape. I go to CVS to pick up Cordran Tape and the pharmacist tells me that I need preauthorization from my dermatologist before I can get Cordran Tape. I’m not familiar with preauthorization, but she tells me I just need to tell my doctor about it and he’ll get it sorted out. I email my doctor (it’s the easiest/fastest way to get to him because getting him on the phone is damn-near impossible) and tell him I need preauthorization to get Cordran Tape. He replies and CC’s his assistant to see what I need to make sure I can get the Cordran Tape. I emailed the dermatologist twice during a span of a week to keep track of what’s going on. Upon the first reply to my email, my dermatologist’s assistant says the preauthorization stuff is “pending.” Upon the second reply, I was told that the preauthorization is denied. I got a letter in the mail confirming the denial. So my question is, is there anyway I can appeal this decision? If so, what steps can I take to heighten my chances of getting my Cordran Tape covered? What steps do I even to take (e.g. what Cigna department do I even call? Any tips/suggestions?) Is it possible that the preauthorization didn’t get accepted because my dermatologist didn’t accurately explain why I’m in desperate need of Cordran Tape? Should I ask my dermatologist to re-appeal or should I do it on my own? Thanks! submitted by /u/SweetenedCafe [link] [comments]Read Morer/HealthInsurance