We Chase the Approval So You Are Not Calling Two Offices
You hand over a prescription and hear that your plan will not pay for it yet. It wants approval first. Nothing is wrong with the prescription and nothing is wrong with your coverage. There is a form sitting between you and your medication.
Most people leave at that point and start dialing. The doctor's office says the pharmacy has to send something, the plan puts you on hold, and the prescription sits unfilled for a week. At our Culver City counter, that round trip is ours to make.
What happens after the claim comes back
Read the rejection
The plan states its reason in code. We translate it before you hear the word no.
Move the paperwork
We pull the right form and get it to your prescriber with the criteria attached.
Stay on the plan
We call for status and tell you the answer instead of waiting for a letter.
We bill every insurance plan, so the plan behind your rejection is one we already work with weekly.
What actually holds up an approval
A missing code, not a refusal
Plenty of rejections come down to an absent diagnosis code or a quantity the plan caps, which a form fixes without your doctor writing anything new.
Proof you tried something cheaper
When a plan wants evidence that a lower cost drug came first, your fill history at this pharmacy is the record it is asking to see.
A form nobody sent
Approvals stall most often because the request never left an office, so we confirm it arrived rather than assume it did.
Something to take home meanwhile
Ask what the cash price looks like, since our discount pricing through Inside Rx, RxSpark, and Optum Perks can cover you while a decision is pending.
Ours to do
- Get the form and the plan's approval criteria.
- Send both to your prescriber and confirm receipt.
- Follow up with the plan until there is a decision.
- Tell you the outcome and what the options are if the answer is no.
Bring or tell us
- Your current insurance card, front and back.
- The name and office of the doctor who wrote it.
- A phone number we can reach you at same day.
- Approvals only move while offices answer, so Monday to Friday, 9:30 AM to 5:00 PM is when this progresses.
Tell us the drug and your plan, and we will start the approval today.
Call 310 919 4100 →