Prior authorization with branded EYE drop products not covered on Insurance Plans

**newdoc** · 02-20-2012, 10:39 PM

How have you been able to get a branded product for a patients when there plan does not cover it?

Thanks

**chip anderson** · 02-20-2012, 10:51 PM

Write an Rx, tell them to take it to pharmacist. Tell them you are sorry but they are gonna have to pay for it out of thier own pocket. Or is this the inconcievable in the world now?

Chip

Remember when people used to take care of thier own needs?

**braheem24** · 02-21-2012, 12:25 AM

Having insurance IS taking care of your own needs.

**cocoisland58** · 02-21-2012, 07:05 AM

Originally Posted by newdoc

How have you been able to get a branded product for a patients when there plan does not cover it?

They either pay out of pocket, you write the Rx for the next best thing or you give them some samples out of your drawer.

**LENNY** · 02-21-2012, 10:43 AM

There is no NON branded drops that we prescribe.....
Most are branads....

**AustinEyewear** · 02-21-2012, 12:33 PM

Originally Posted by newdoc

How have you been able to get a branded product for a patients when there plan does not cover it?

Thanks

Working on one right now. Wrote a letter to the ins co. Unable to maintain coorelation between dosage and results due to inconsistent production across different generic factories. Is that your same concern?

**Pvtcjhalo** · 03-06-2012, 05:46 PM

We had this problem the other day...The patients insurance did not cover ANY gtts for dry eye, she was on a mild anti inflamitory. Her "pharamcy tech" recomended switching her to a generic GLAUCOMA gtt (OMG). We wrote scripts for 3 drugs and told her that we are sorry but we cannot have the insurance company dictating what treatment works for her and that she should shop around for the best price.

**Pvtcjhalo** · 03-06-2012, 05:48 PM

Also for drugs like Restasis, with no generic....the pharmacy will fax over a prior auth to fill out and send to the insurance company. They review it and decide within 2 weeks. (We did this everyday when I worked for an MD. Being a trigage tech meant you sat and filled out those forms all day and did refill requests :)

Also it was the patients responisbilty to provide us with all the paperwork needed. I am not going to have my staff waste hours getting paperwork for a service that we make NO money on. Bring me the forms and I will fill them out. It is amazing how many patients think it is MY job to find out their insurance information....errrgggg