A Prior Authorization (PA) is a requirement some insurance providers have in place that allows them to review certain medications before it is decided if they will be covered.
Insurance providers want to know if the medication is medically necessary and appropriate for the patient’s situation before they approve or deny the PA.
Please note that this may cause a delay in processing the prescription, as PAs can take anywhere from 3-10 business days, depending on the responsiveness of your doctor and your insurance provider.
Prior Authorization Process:
At your doctor's request, we will collect the needed forms from your insurance company for your Prior Authorization.
Step 1: We will fill out your Prior Authorization form
Step 2: We will send it to your provider to ask them to submit it to your insurance
Step 3: We will follow-up with your provider on the PA submission to your insurance
Step 4: If your insurance accepts the Prior Authorization, we will ship your prescription. If your insurance denies the Prior Authorization, we will contact you regarding alternate options and next steps
If you receive a Prior Authorization determination from your plan, please send us either a PDF scan, photo or screenshot of the determination by email to help@usephil.com, or by SMS to 744-579. If we have not already received the determination, we will update your prescription and provide you with you with an updated price within 1-3 business days