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How to get a Hydromorphone prior authorization approved under 5 business days?

Prior authorizations can feel like quicksand. Pharmacies say they’re waiting, doctors say they already faxed, insurance companies say they never got anything. In the middle of all this, patients are left without their medication. That’s where our outsourcing team comes in. This case was for Hydromorphone, which is heavily monitored and requires extra documentation. The patient couldn’t afford weeks of back and forth. Here’s how it unfolded. Day 1 – Tuesday: First Call The patient reached out because the pharmacy

Noah Thomas

Healthcare professional explaining kidney function using a kidney model; represents chronic kidney disease treatment discussion.

Outsourcing Prior Authorization

What’s the Process for Sevelamer Prior Authorization in CKD?

In healthcare, obtaining insurance prior authorization (PA) for essential medications can be a bit of a journey, especially when it comes to specialized treatments. This guide walks through a recent case of securing PA for Sevelamer Carbonate, a crucial medication for managing chronic kidney disease (CKD). Used to help reduce high phosphate levels in CKD patients, Sevelamer is an effective solution but often comes with the challenge of needing prior approval from insurance companies. Let’s look at how we navigated