Wiki Help with Pharmacy required paperwork

[LNader]

Has anyone else received paperwork from the pharmacies that the physicians need to fill out before the prior authorization will be approved? We received 5 pages from a pharmacy asking about any other medication that was tried, what the dosage would be, just all sorts of questions before the authorization would be approved. Is there a way we can charge for this if it is going to be an ongoing requirement? Any response appreciated.

 

[csperoni]

I am unaware of any charge you can bill for authorizing your recommended treatment - just like a surgery pre-auth or a radiology pre-cert. It's the cost of doing business.
If it is a specific medication that you prescribe on a regular basis, sometimes the drug manufacturer can be of assistance. For example, Orlissa was just approved a few months back for endometriosis. The rep from Orlissa has given us guidance about which carriers cover it, and what documentation is typically asked for with insurances that require auth.