Forteo Reauthorization - Osteoporosis Message Board

taape · 08-29-2005, 06:05 PM

I just filled my last prescription for the pen and my one year authorization from the insurance company ends next month. Has anyone here had to get reauthorized for the second year? Were you required to get a repeat DEXA scan? I have an appointment with the Endocrinologist on Wednesday to go over this. This will be a new doctor as the first one left shortly after, and the other guy was a jerk. I'm just wondering how hard it will be to get them to pay for the second year. Thanks for any replies.

PatNJ · 08-29-2005, 07:51 PM

I'm wondering, taape, if you should call your ins. co. before you see the doctor on Wednesday, to find out what they will require in the way of physician documentation, repeat scan, etc.; that way, you'll be able to tell the guy (and his staff) exactly what they need to do to expedite your next refill. You obviously don't want there to be too long a lag before you get the authorization in place, since you are down to your last pen.

taape · 08-29-2005, 08:59 PM

I called the Corporate Office and talked to the individual that arranges for the initial authorizations. He says that he doesn't do reauthorizations and couldn't give me a name of anyone, just the number that the doctor is needing to call. I'll try that number tomorrow. I could pretend to be a doctor, I've done that before with a different insurance company that wouldn't authorize a specialist appointment. When the person in that dept. found out she was so mad. I had an urgent issue and my doctor was dragging his feet. I got it done for myself.

PatNJ · 08-30-2005, 12:29 AM

I think it sounds like a good idea, taape. The worst thing that can happen is that you won't find out anything useful, and then you'll just have to stay on top of your doctor's office after Wednesday, to get the ball rolling. (Perhaps "just" should be in quotation marks!)

spinewhine · 08-30-2005, 04:39 PM

Maybe I'm naive, but since the course of treatment with Forteo is generally two years, I can't see why re-authorization would be a problem. Your doctor wouldn't have put you on it if you didn't qualify and the insurance has been covering it. I assumed that my one-year rather than two-year prescription just guaranteed the doctor that I'd return in a year so he could check me out, make sure everything was in order before giving me the new prescription. I'd certainly be interested in knowing if anyone had a problem with re-authorization.