Prior auth requirements and denials
My orthopedic surgeon recommended knee surgery. Submitted prior auth and insurance denied it saying I need to try 6 more weeks of physical therapy first. Ive ALREADY done 12 weeks of PT with no...
Insurance changed their formulary and now a medication Ive been taking for 5 years requires prior auth. Doctor submitted it, denied. Appealed, denied again. Now I have to try two other medications...
Wanted to share my experience with a pre-authorization claim since I learned a lot from this community when I started.Filed in October, adjuster came out within a week. Initial offer was about 40% of...
Got the denial letter today for my pre-authorization claim. They're saying its not covered but I dont understand why.Has anyone successfully appealed something like this? Do I need a lawyer or can I...