Is there any other class of medications that are routinely reduced by a #pharmacy/ #pbm? It just baffles me how discriminatory policies that put barriers in place are allowed to continue. How do Mds feel about being second-guessed constantly by these companies? #DEACenteredCare
It makes sense for a #PharmD to call an MD for a script that THEY (using the years of schooling and clinical judgment that results) deem questionable. What doesn’t make sense is mandating this and using it as an excuse to deny patients their RXs. It’s cruel.
Also, what you don’t see here is once the PA is sent in, it will automatically be rejected. And when the second one is sent, that one will also be rejected. They will give different reasons each time. The process starts all over again when the appeal to the actual ins. co begins.