I’ve been dealing with a back and forth with Cigna, Express Scripts, and my doctor’s office for a few weeks now. Evidently my doctor did not include part of my medical records in their prior authorization for a medication, which ended up being the reason for denial. They have since attempted to upload, fax, call in, certified mail, etc. multiple times to the plan, but keep being told nothing is received.
I have the records myself and have tried to file an appeal, but Express Scripts tells me this is not appealable or grievance-able because “medical and pharmacy are separate and you cannot file anything with ES because you are not a provider”
I don’t know what else to do and I’m down to 6 pills. The only solution they’ve given me is to apply for NeedyMeds, pay out of pocket, or (seriously) call my EAP to deal with my frustration. Does anyone know whom I can talk to to try and figure this out?
based in California. income ineligible for assistance programs, but the medication is thousands, i cannot afford to pay out of pocket for any extended amount of time
submitted by /u/MyDisneyExperience
[link] [comments]I’ve been dealing with a back and forth with Cigna, Express Scripts, and my doctor’s office for a few weeks now. Evidently my doctor did not include part of my medical records in their prior authorization for a medication, which ended up being the reason for denial. They have since attempted to upload, fax, call in, certified mail, etc. multiple times to the plan, but keep being told nothing is received. I have the records myself and have tried to file an appeal, but Express Scripts tells me this is not appealable or grievance-able because “medical and pharmacy are separate and you cannot file anything with ES because you are not a provider” I don’t know what else to do and I’m down to 6 pills. The only solution they’ve given me is to apply for NeedyMeds, pay out of pocket, or (seriously) call my EAP to deal with my frustration. Does anyone know whom I can talk to to try and figure this out? based in California. income ineligible for assistance programs, but the medication is thousands, i cannot afford to pay out of pocket for any extended amount of time submitted by /u/MyDisneyExperience [link] [comments]Read Morer/HealthInsurance