My patient met the insurance company's prior authorization criteria, which was reasonable. Yet, the authorization was rejected, so I appealed. It was rejected again, even though I pointed out to the agent on the other end of the line that the patient met the criteria. I was about to give up, but decided to call the medical director of the insurance company instead, who granted authorization. I wonder how many people would have given up rather than continue the fight and how much money the insurance company thought it was saving by denying legitimate drug use.

First Name: 
Susanna
Last Name: 
L.
State: 
State
E-mail address: 
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Share your story

Have you ever gone to the pharmacy to fill a prescription only to be told that your insurance company requires approval before they'll cover your treatment? Have you ever waited for days, weeks, or months for a test or medical procedure to be scheduled because authorization from an insurer? Or are you a physician frustrated with the administrative headaches and their impact on your patient?

Prior authorization is a burden on patients and physicians alike. The process is confusing, time consuming, and — most importantly — can cause delays in patients receiving the care they need.

Please tell us know how prior authorization has impacted you. We are looking for stories from patients and physicians to highlight and draw attention to this issue that is impacting the health of so many Americans.