For Physicians and Their Patients
Submitting a prior authorization claim means securing and completing the appropriate claim form for the patient’s disease and the drug(s) prescribed, plus gathering relevant medical records.
- Once complete, the claim is submitting by mail or fax to the payer (insurer or PBM).
- Patient Support Programs or Drug Access Navigators are often involved in the process to ease the administrative burden for prescribers and their patients.
- Even with assistance this can be an administratively burdensome and time-consuming process.
As a result, there can be a significant time lag between prescribing and patients receiving access to their medication.