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Why we are needed

Prior Authorization is an administrative burden on providers that takes valuable time away from them and their patients. Here are some quick facts about the current state of prior authorizations (PAs):

  • Providers spend an average of 14 hours a week (almost two full business days) working on prior authorizations and do an average of 45 prior authorizations per week (per provider!) This is an average of about 20 minutes per PA request (much of which involves just finding the right form!

  • 91% of providers say that a PA has had a negative impact on their patient.

  • 1/3 of providers report having had a patient experience a severe adverse effect due to the prior authorization requirement, with 9% reporting that it led the patient to have a disability and/or permanent damage

 

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Pharmacist at Work

What we provide

For each client, we create a comprehensive prior authorization and/or appeal request that includes the coverage criteria for the medication from your insurance company, relevant health information related to the coverage criteria and relevant current medical literature to support approval of the prior authorization request

Our Services

We work with each client to help them solve their medication coverage problems in a personalized way.  We help people in three basic ways, but if you have another medication coverage issue please reach out to us and we will see if we can help! 

Prior Authorization Support

We offer prior authorization support services to help you get the medications you or your loved ones need. We will develop a prior authorization request form that includes all the required information by your insurance company. We help navigate the prior authorization process and work with your healthcare provider to ensure that you receive the treatments you need.

Medication Appeals Assistance

If your insurance company denies coverage for a medication, we can help you navigate the appeals process. We provide comprehensive appeals management services to help turn denials into approvals.

Other Medication Coverage Assistance

If you have other medication coverage problems, we may be able to help! Please get a hold of us and we will see what we can do for you!

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