Prior Authorizations for Medications Notice

Prior authorizations (PA) for medications are usually required for high cost, brand only or specialty medications. Your insurance plan determines whether a prior authorization request is required.

We are no longer processing prior authorization requests for medications after January 2024. If you receive a notification from the pharmacy that a PA is required, you will need to schedule a follow up medical visit to choose an alternative medication or for a referral to a specialist who will determine if the specialty medication is the right option for you.

For all patients who received medications requiring prior authorizations prior to January 2024 you will need to complete the following steps.

1. If your request has been approved, you need to fill the medication as recommended by Dr. Giles. If your PA has an end date, then you will need to follow up for a specialist referral when the current PA has expired.
2. If your request has been denied, you will need to call your insurance plan to obtain a list of alternative options. Then, make a follow up appointment so that Dr. Giles can determine a suitable alternative that is covered by your plan.

Thank you for your cooperation.