Blog

How to Resolve ‘Cannot Find Matching Drug’ Errors During Prior Authorization in Bangor, Maine?

Getting a “Cannot Find Matching Drug prior authorization  error in Bangor, Maine? It’s a common roadblock that slows down prescriptions and adds frustration for providers. When the system fails to recognize a medication, it’s not just about waiting—it’s about preventing delays that impact patient care. If you’re dealing with matching drug prior authorization issues in Bangor, you need a clear, no-nonsense way to resolve them fast.

Let’s break it down and fix this matching drug prior authorization mess in Bangor, Maine—step by

Step 1: Figure Out Why the Drug Ain’t Matching

First things first, why is the insurance system having a meltdown over your drug entry?

• Drug Name Mix-Up: Maybe the name is entered slightly diffirent from what’s in the insurance formulary. Even a tiny typo can throw things off.
• Wrong NDC Code: The National Drug Code (NDC) has to be spot on, including the correct package size.
• Old Formulary Data: Sometimes, insurers haven’t updated their systems with the latest drug info. Yep, that happens.
• Unnecessary PA: Some drugs don’t even need PA anymore, but the system still flags them.

What to do? Double-check everything before hitting submit. If it still gets rejected, don’t stress—we’ve got more tricks up our sleeve.

Step 2: Check the Insurance Formulary

Not all insurances cover every medication the same way. Some need step therapy (ugh), some require alternative approvals, and some just straight-up deny coverage unless you go through hoops.

Quick Fix:

• Log into the payer’s portal and pull up their latest formulary list.
• Check if the drug needs prior authorization or step therapy first.
• See if there’s a therapeutic alternative that doesn’t need a PA.

Pro tip: The formularies change A LOT. Yesterday’s approval might be today’s rejection.

Step 3: Fix the Drug Code and Try Again

If the rejection is because of an NDC code issue, here’s what you do:

1. Grab the exact NDC code from the package. Not from memory. Not from an old list.
2. Make sure the dosage strength & package size match the payer’s database.
3. If you’re billing under medical benefits, check the HCPCS or CPT codes too.
4. Re-submit the claim with the updated info and cross your fingers.

Pro Tip: Some insurance portals are picky and only accept certain submission for

mats. If you’re using a generalized PA request form, it might get rejected no matter what.

Step 4: Call The Insurance (Yep, You Have To)

If resubmitting doesn’t work, it’s time to pick up the phone (I know, I know).

• Ask them why the drug isn’t showing up.
• If the first rep can’t help, escalate to a supervisor (because sometimes they have better access).
• Some insurers have a manual override option if their system is at fault—ASK for it.

Shortcut: If you can get your pharmacy rep to call on your behalf, do it. They usually have a more direct line to the payer’s internal team.

Step 5: Try a Different Submission Method

Okay, if electronic submissions keep failing, time for Plan B.

✔ Fax the request instead (yes, people still use fax)
✔ Manually upload a request through the insurer’s provider portal
✔ Request an exception review if the patient really needs this medication with no alternatives

Some insurers accept real-time PA processing, so if you have that option in your EHR, use it. If not, fax might be faster than waiting on hold for hours.

Step 6: Get a PA Service to Handle It

Let’s be real—prior authorizations are a full-time job no one signed up for. If your team keeps running into these issues, it might be time to outsource.

• Use a third-party PA service to take care of the paperwork (like Staffingly, Inc.) 
• Automate PA requests using AI-based tools for faster approvals
• Pre-validate prescriptions to check insurance requirements before submitting

What Did We Learn?

Alright, let’s recap the roadmap so you don’t get stuck dealing with endless PA rejections:

✅ Check drug name, NDC, and formulary before submitting

✅ Use the correct HCPCS/CPT codes for medical billing
✅ Call insurance if the system refuses to match the drug
✅ Try alternative submission methods if electronic PA keeps failing
✅ Consider outsourcing PAs to avoid the headache

By following these practical steps, you can save time, reduce rejections, and make prior authorization a little less painful. 🚀

What People Are Asking ?

1. Why does the system say “Cannot Find Matching Drug”?

It’s usually due to name mismatches, incorrect NDC codes, outdated formularies, or system errors.

2. What should I do if my PA keeps getting denied?

✔ Double-check the NDC and formulary
✔ Call the insurer for details
✔ Try faxing instead of electronic submission
✔ Request a manual review

3. Can I submit a PA without an NDC code?

No, most insurers require an exact NDC for approval. Use the correct package size and dosage.

4. How long does it take to fix this error?

It varies—some fixes are instant, but manual reviews can take a few days. Calling speeds it up.

5. How can I avoid these issues?

✔ Use a PA service
✔ Automate with AI-driven tools
✔ Pre-check formularies before prescribing

Disclaimer

The information in our posts informs and educates healthcare providers and readers seeking a better understanding of healthcare processes.

This content does not establish any patient-caregiver or client-service relationship. Staffingly, Inc. assumes no liability for actions taken based on information provided in these posts.

For tailored support and professional services,

please contact Staffingly, Inc. at (800) 489-5877

Email : support@staffingly.com.

About This Blog : This Blog is brought to you by Staffingly, Inc., a trusted name in healthcare outsourcing. The team of skilled healthcare specialists and content creators is dedicated to improving the quality and efficiency of healthcare services. The team passionate about sharing knowledge through insightful articles, blogs, and other educational resources.