What's important to understand: We as your primary care team have no control over whether your prior authorization gets approved—this decision rests entirely with your insurance company. When we prescribe a medication or order imaging, it's because we've already determined it's medically necessary for your care. The prior authorization isn't questioning the medical need, it's simply your insurance company's approval process that we must navigate together.

Your insurance is essentially asking us to prove why you need this treatment, even though we've already deemed it necessary. Unfortunately, our medical expertise alone often isn't enough in their eyes. Even after we provide all requested documentation, approval isn't guaranteed and ultimately depends on your specific plan's coverage.

This process can take anywhere from days to weeks, and sometimes results in denials even when the treatment is clearly medically appropriate.

Rest assured, we'll always advocate for you and work diligently to get your medications and imaging approved. You deserve the care I've prescribed, and we won't give up on getting it for you!

Want to learn more about navigating prior authorizations and insurance challenges?