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Richard DelVecchio

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Skip the appeal with denial reconsideration

Posted by Richard DelVecchio on July 16, 2019

Have you ever filed an appeal because a prior authorization (PA) was denied? Of course, you have. We receive an average of 60 appeals requests per month. Many of these appeal requests, especially the ones for prescription drugs, don’t require an appeal for a favorable outcome. In fact, at least half of all prescription drug PAs that are denied for not meeting medical criteria were subsequently approved once we received additional necessary information. 

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Topics: Doing Business with Providers, Insider