The insurance company, doctor's offices and pharmacy are all giving me a headache as well. In early October I went to my pain management doctor and he suggested trying something different for pain, Nucynta. Several of my friends are on it so I decided to give it a try when my doctor suggested it. I took the prescription to the pharmacy. They didn't carry it so I had to have them order it. When you sign on with a pain management doctor, you have to sign a contract that says that you will use only one pharmacy and only one pain management doctor. A week later I got the call that the medication was in the pharmacy. We my husband was on his way to pick it up, I got a call from the pharmacist that the medication wasn't approved by the insurance company. Now they couldn't have check this before they ordered it so that we could have been working on the authorization while waiting for the medication to be ordered? Of course that would be too easy!!
So the pharmacist said that she would fax the denial to the doctor's office. I called the doctor's office to aler them to be on the look out for the form. Two weeks later, I still haven't gotten a letter from the insurance company about their ruling; so I gave then a call. It seems that the preauthorization was never sent to them. I got on the phone to speak to the doctor's office and they said that they never got any paperwork from the pharmacy. I told them that I had called them to tell them to expect the form..and they couldn't call me to tell me that they didn't recieve it so that I could follow up? So I went to the pharmacy to talk to the manager. She pulled out the fax verification form in an attempt to show me that it wasn't their fault (no of cours it's no one's fault, right?). When she pulled the form it said "fax busy" and they never resent it or followed up in any way. So now I've waiting three weeks for this pain medication without anything for pain. I went on the insurance company's web site and printed the preauthorization form and faxed it to the doctor myself. I called to be sure that they recieved the form. Now we wait, again to see what the insurance company says. It is so frustrating to have to go through all of this when you have a diagnosis that says that you have one of the most painful diseases that there is and you are fighting for pain medication. It never ceases to amaze me the ways that they try to torture us over our healthcare!!
For CRPS/RSD Awareness Month, here is today's post:
For my friends who are nurses, this is progress!