Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
How long does it take your doctor's office to submit a pre-authorization request to your insurance?
My insurance usually processes them within 72 hours but my doctor's office took almost 2 weeks to just send over the forms to them. Is this normal?
It was really frustrating while I am sitting in pain to wait on the office to fax it over.
My insurance usually processes them within 72 hours but my doctor's office took almost 2 weeks to just send over the forms to them. Is this normal?
It was really frustrating while I am sitting in pain to wait on the office to fax it over.
I was lucky I guess as the office staff was working on the submittal by the time I checked out and was setting up my next appointment, in fact they were so efficient that they did not have the results of my TB test ( which they just took blood for that day) when they first submitted, so they had to resend a few days later with those results!
I have read from others that they have been delayed for quite a while because of submittal issues.
I think it is probably worse this time of year with people busy with the holidays, etc.
Good luck, hope things move quickly from here on out for you!
Average for me from point A of the doc saying to start on Humira or Enbrel to point B of me having the med in my hands is about 3 months.
Of course, the holidays have not been helping but it took over a week for everything to be pre-authorized and nobody was calling me or telling me why. I finally called and my insurance kept saying my doctor wasn't sending anything. I have been arguing back and forth with my doctor, insurance and my pharmacy for this dang prescription!
I'm moving from PA to NC in 2 weeks and I NEED this medicine. Still don't have it and the pain isn't going away. I never had this much trouble with any previous order. Ridiculous.
Good luck to you!
Although my first bio Enbrel I recieved a call from the speciality pharmacy the next day. In fact I recall the office stating back then it could be up to one week.
Holidays may be holding things up but who knows anymore.
Once that preauth is done you should hear something from pharmacy sooner then later.
My doctor appeared surprised that mine took so long. Right hand does not know whst the left hsnd is doing. Not a good thing.
Just so you know how the office runs ask the doctor next visit how long you should wait for this whole process.
With luck That should give you some insight on the office.
Sammy
One is a non-biologic and he fills out the form, gives it to the nurse who gives me the fax confirmation when I'm checking out. Insurance has 72hrs to approve & process. Its good for 90days.
The rheumy does everything electronically. She sends over the rx and pre-auth form from her laptop. Then I call the specialty pharmacy when I get home to make sure they rec'd it and see if they need anything else. I'm not sure if they have a timeframe they have to follow. Enbrel was delivered in less than 2wks. Remicade took about 3wks before the office called to schedule the infusion.
I pay a fortune for my Cobra premiums but I've been really lucky with my ins co.
Maybe the holidays and staff taking vacations slowed things up at your dr's office. Hopefully they can get back on track. If I were you starting Monday, I'd be ringing their phone off the wall til you got your medicine. Sometimes being a PITA is the only way to get what you need.
Take care,
Emerald
Next time I should take the forms with me...maybe that will speed up the process.