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What strategies have you found most effective for obtaining prior authorization for newer antipsychotics and antidepressants?

How do you determine which medications are most likely to require prior authorization? How do you streamline the prior authorization process and fit it into a busy clinical schedule? What clinical rationales or documentation approaches have you found improve approval rates? How do you handle denials?
3 Answers
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Psychiatry · Kirk Kerkorian School of Medicine at UNLV
Answered on · Updated on

I attempt to avoid all insurance issues, as I have a cash-based outpatient practice, and make it clear to patients that my interactions with their insurers will be minimal, if at all. But what I have found, in limited cases, is that demonstrating a failure on 2 of the formulary-approved choices tend...

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Psychiatry · Private Practice
Answered on

My EMR has an integrated PAR feature. It is clunky; the other resource is CoverMyMeds. You have to enter basic demographics of the patient, but the interface will send the information to the insurance company. Many times, the approval is automatic. If not, there is a "further information" which is a...

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Mednet Member
Psychiatry · Diversified Counseling Services
Answered on

One of the most frustrating areas for me whenever I receive a preauthorization request - sometimes most unexpectedly.

Sometimes, the request is coming immediately within my e-prescribing program - these tend to be easiest to complete, asking for a diagnosis and a few questions, but sometimes, also r...

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