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Appeal 08 2391 Form

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prior authorization is a submission to insurance to pre-approve medication of service or a therapy that they deem as needing to be reviewed before it can be administered usually when a prior authorization is denied it means that they have the insurance company have deemed it like not medically necessary or it doesn't fit the criteria that they have written in their specific plans earth appeals are mainly about the medications that are provided a lot of them are new not fda-approved so we have to do a lot of research to get the pharmacist involved finding literature to provide to the insurance companies we typically contact the family first and let them know that it was denied and let them know that there are multiple steps that can be taken the first one is a peer to peer review which we contact the physician and then they can choose to contact the insurance companies from there and talk physician to physician over there to see if they can get the denial overturned if that does

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