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home:mp:insurance [01.08.2013] – [Appealing a denial for Benicar] sallieq | home:mp:insurance [01.08.2013] – [Appealing a denial for Benicar] sallieq | ||
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- The initial problem may be with the pharmacy, which sometimes has upper limits on the dose and frequency of certain medications. Sometimes this will need to be overridden by one's insurance company. | - The initial problem may be with the pharmacy, which sometimes has upper limits on the dose and frequency of certain medications. Sometimes this will need to be overridden by one's insurance company. | ||
- Other times all that is needed to override an initial denial is a phone call from the doctor' | - Other times all that is needed to override an initial denial is a phone call from the doctor' | ||
- | - If a doctor override is not sufficient, accept the standard amount of pills until the insurance company approves the increased dosage. | + | - If a doctor override is not sufficient, accept the standard amount of pills until the insurance company approves the increased dosage. |
- Contact the insurance company and ask if their doctors produced a letter of medical necessity would allow for full coverage of Benicar (see below). | - Contact the insurance company and ask if their doctors produced a letter of medical necessity would allow for full coverage of Benicar (see below). | ||
- Ask for an explanation of the decision and the specific rationale why the claim was denied. The reason given will dictate the peer-reviewed papers and other materials presented to the insurance company. | - Ask for an explanation of the decision and the specific rationale why the claim was denied. The reason given will dictate the peer-reviewed papers and other materials presented to the insurance company. |