Provider: Dear Pharmacy, please fill this medication for my patient.
Pharmacy: Dear Insurance, please pay for this for my patient.
Insurance: Dear Pharmacy, this needs a prior authorisation.
Pharmacy: Dear Provider, this needs a prior authorisation.
Provider: Dear Insurance, please approve this medication for my patient.
Insurance: Dear Provider, this medication does NOT require a prior authorisation.
Provider: Dear Pharmacy, this medication does NOT need a prior authorisation.
Pharmacy: Dear Insurance, provider said you told them this does NOT need a p/a.
Insurance: Dear Pharmacy, this does, in fact, require a p/a.
Pharmacy: Dear Provider, insurance says it does, in fact, require a p/a.
Provider: Dear Insurance, WTF?
Insurance: Dear Provider, it does not need a p/a.
Provider: Dear Pharmacy, they said it needs no p/a.
Pharmacy: Dear Insurance, WTAF?
Insurance: Dear Pharmacy, it needs a p/a.
Pharmacy: Dear Insurance, is it a specific manufacturer? Specific NDC?, Specific form or size?
Insurance: Dear Pharmacy, no. It just needs a p/a.
Pharmacy: Dear Insurance, do you have a list of alternatives?
Insurance: Dear Pharmacy, yes. (lists alternatives)
Pharmacy: Dear Insurance, you do realise that the medication I am submitting is on your preferred list, right?
Insurance: Dear Pharmacy, meh. With a p/a, it is.
Pharmacy: Dear Insurance, Where do we go from here?
Insurance: Dear Pharmacy. You give up.
Pharmacy: But how does that help my patient?
Insurance. It doesn't.
Pharmacy: What's your endgame?
Insurance: You give up. Or the patient gives up and pays cash. Or the provider gives up and prescribes something else. In the end, you will be blamed by all parties. We won't have paid for something more expensive, and we will audit you for not documenting all of this to our satisfaction and take back any money you received from us for this claim and a select few others. We're basically trying to put you out of business.
Pharmacy: Dear Insurance, thanks for the honesty.
Insurance: No problem. Anything else I may assist you with?
Pharmacy: Well, since you haven't helped me with anything yet, I suppose that's a rhetorical question.
Insurance: It is. <click>
#WhyYourPrescriptionTakesSoLong
#YouCantAlwaysGetWhatYouWant
#WeTried
#ItHurtsBecauseItsTrue
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