Q: What is a Prior Authorization?
Answer: A prior authorization occurs when your insurance company requires more information before paying for a medication your Doctor has prescribed. In order to rectify this situation the pharmacy contacts your doctor’s office to alert them that insurance requires a prior authorization (PA) and they will need to contact the insurance. The Doctor will then contact the insurance company to explain why you need the medication. The insurance will either approve or deny the doctor’s request. If the request is approved the Doctor will notify the pharmacy who will then process the claim. If the request is denied the Doctor will either appeal it or change the medication. PA’s can take a few hours or several weeks depending on your insurance. You always have the option to pay cash if you so choose.