Prior Authorizations
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Information you may need
Prior Authorizations
Many medications and imaging require a prior authorization before insurance will approve or deny payment. Your insurance requires this to give them time to review the “medical necessity” of the medication or test being prescribed. If a prior authorization is required, your pharmacy or Radiology facility will contact your provider who will provide the necessary information to your insurance. Depending on your insurance, this may involve several steps by your providers office, radiology facility and/or pharmacy. Please allow our office 3-4 weeks to process this request. We will inform you once insurance approves or denies coverage. Neither your provider or pharmacy/imaging facility can guarantee coverage of a medication/test. Please check with your pharmacy or insurance for updates.
If you are requesting a new medication for weight loss, please contact your insurance first to inquire if weight loss is covered under your plan before an expensive medication such as Wegovy or Saxenda, will be prescribed by our office. Note, Ozempic is not FDA approved for weight loss without a diagnosis of Diabetes. Therefore, this medication will not be prescribed for diagnosis of weight loss alone. If a medication is prescribed and requires a prior authorization, please allow our office 4 weeks to process this request. Please contact your insurance or pharmacy for a status update on your authorization.
If you are requesting a new medication for weight loss, please contact your insurance first to inquire if weight loss is covered under your plan before an expensive medication such as Wegovy or Saxenda, will be prescribed by our office. Note, Ozempic is not FDA approved for weight loss without a diagnosis of Diabetes. Therefore, this medication will not be prescribed for diagnosis of weight loss alone. If a medication is prescribed and requires a prior authorization, please allow our office 4 weeks to process this request. Please contact your insurance or pharmacy for a status update on your authorization.
