Services
Insurance Authorization Help
Dealing with a denied insurance claim can be confusing and stressful when you need your medication. At Nine Mile Rx, we specialize in navigating the complex prior authorization process to ensure you get the treatment prescribed by your doctor without unnecessary delays.
How We Advocate for You
- Direct Provider Coordination: We contact your doctor immediately to gather the necessary clinical information and medical records.
- Paperwork Management: Our team handles the submission of forms and digital requests required by your insurance plan.
- Status Monitoring: We track the progress of the claim and keep you informed every step of the way so you are never in the dark.
- Alternative Solutions: If a specific drug is not approved, we work with your physician to find covered alternatives or manufacturer discounts.
The Independent Pharmacy Difference
Unlike big chains that might simply tell you a prescription is rejected, we take the time to fight for your coverage. We understand the local healthcare landscape in Ferndale and work tirelessly to resolve billing issues so you can focus on your health.
Let Us Handle the Red Tape
If your medication requires approval or you are facing high copays, let us help you find a solution. Call us at (248) 305-2275 or visit us on East Nine Mile to speak with our pharmacist.
Frequently Asked Questions
Your Questions, Answered
We’ve gathered answers to the most common questions to help you understand our services and make the most of your experience with us.
This is a requirement from your health insurance company that your doctor must obtain approval before the plan will cover the cost of a specific medication. It essentially asks the insurance company to review the medical necessity of the drug before you pick it up.
Rejections often happen because a medication is not on your insurance plan's formulary, is an expensive brand name drug, or requires confirmation that other treatments were tried first. We can help determine the specific reason and start the approval process.
The timeline varies depending on how quickly your doctor's office responds and your specific insurance plan, but it typically takes between 24 to 72 hours. We monitor the request daily to ensure it moves as fast as possible.
In most cases, you do not need to call them. Our pharmacy team works directly with your doctor and the insurance provider to handle the submission and follow up on your behalf.
If the request is denied, we will work with your doctor to switch you to a therapeutically equivalent medication that is covered by your plan, or we will help you look for manufacturer coupons to lower the out of pocket cost.