Re: has anyone had to go through re-authorization?

[Guest guest]

,

this is absolutely the place to post your frustration with having to

go through reauthorization. Also, your post is very important as a

potential warning to the rest of us. I haven't had this problem yet,

but my last batch of vials (which I'll use this Sunday), says " 0

refills left. " I've been wondering if I will have to be

reauthorized. I had a ton of refills when I started 7 months ago and

have finally worked down to the last of the prescription, I guess.

I'll contact my doctor's office and find out if they've had to do

that or if I'm on " automatic " so to speak.

Please let us know the outcome, and whether or not you have to miss

any doses because of this situation. Also, be sure to mention it

during the chat. I think that a Genentech rep and a Curascript nurse

will be participating.

Addy

________

>

> is it okay to post stuff like this here??

> heather

[Guest guest]

thanks for the reply, in both places!! i can only hope that they

move quickly with this. i didn't even think of it being an issue

related to the refills on the xolair. i never though to look at

them! i'll be sure to check in the day of the chat with the

curascript people.

i'm hoping the xolair is starting to work. my asthma has improved

(but we also added more meds in march due to a flare, and i'm still

on them so its hard to tell) but i'm fighting a sinus infection -

which i can only assume is allergy related since none of the kids in

my classroom have a cold. luckily, we caught the infection in the

beginning, and we're trying to keep it from traveling to my chest.

thanks again

heather

> ,

>

> this is absolutely the place to post your frustration with having

to

> go through reauthorization. Also, your post is very important as

a

> potential warning to the rest of us. I haven't had this problem

yet,

> but my last batch of vials (which I'll use this Sunday), says " 0

> refills left. " I've been wondering if I will have to be

> reauthorized. I had a ton of refills when I started 7 months ago

and

> have finally worked down to the last of the prescription, I

guess.

> I'll contact my doctor's office and find out if they've had to do

> that or if I'm on " automatic " so to speak.

>

> Please let us know the outcome, and whether or not you have to

miss

> any doses because of this situation. Also, be sure to mention it

> during the chat. I think that a Genentech rep and a Curascript

nurse

> will be participating.

>

> Addy

> ________

> >

> > is it okay to post stuff like this here??

> > heather

[Guest guest]

--- In , " heather " <heaven1975@y...>

wrote:

> i'm so irritated...i started xolair the end of january. about three

> weeks ago, my insurance decided that they needed to reauthorize it.

> so they fax the drs office, to which the drs office faxed

everything

> they requested back to them. i talked to the insurance and they

said

> on the 28th of may they received it, and was waiting to hear from

> curascript...apparently, the insurance has decided that they need

> more info, or just want to have it faxed again. curascript cannot

> send my next shipment out (which i'm due for a shot next thursday)

> so now, i am apparently waiting for the insurance committee to

again

> deam this medically necessary. am i crazy for feeling so mad? am i

> over-reacting?? is this a common thing, that after a few months,

the

> insurance companies feel the need to re-evaluate?

>

> is it okay to post stuff like this here??

> heather

,

You bet! This is the place talk with others like you. I too use

Curascript, but my insurance company did not give me the run around.

Thank the Lord I have a good company that seems to actually CARE

about it's policy holders and their health.

Honestly, I wonder if some insurance companies tell their employee's

to not pay a claim unless it is the very last resort. These companies

could save money by not hiring so many employees to find loop holes

to deny claims.

Hmmmmmmmmmm, that IS a thought!

Doug

[Guest guest]

thanks...my only thought right now is beat them silly with the empty

xolair vials!!!

> > i'm so irritated...i started xolair the end of january. about

three

> > weeks ago, my insurance decided that they needed to reauthorize

it.

> > so they fax the drs office, to which the drs office faxed

> everything

> > they requested back to them. i talked to the insurance and they

> said

> > on the 28th of may they received it, and was waiting to hear

from

> > curascript...apparently, the insurance has decided that they

need

> > more info, or just want to have it faxed again. curascript

cannot

> > send my next shipment out (which i'm due for a shot next

thursday)

> > so now, i am apparently waiting for the insurance committee to

> again

> > deam this medically necessary. am i crazy for feeling so mad? am

i

> > over-reacting?? is this a common thing, that after a few months,

> the

> > insurance companies feel the need to re-evaluate?

> >

> > is it okay to post stuff like this here??

> > heather

>

> ,

>

> You bet! This is the place talk with others like you. I too use

> Curascript, but my insurance company did not give me the run

around.

> Thank the Lord I have a good company that seems to actually CARE

> about it's policy holders and their health.

>

> Honestly, I wonder if some insurance companies tell their

employee's

> to not pay a claim unless it is the very last resort. These

companies

> could save money by not hiring so many employees to find loop

holes

> to deny claims.

>

> Hmmmmmmmmmm, that IS a thought!

>

> Doug

[Guest guest]

Thanks for posting, please keep us updated. I'm sure my insurance

will pull the same crap. It would help me, in dealing with my

insurance, to know what you have to go through. My insurance denied

the Xolair for me. I had to go to the government Independent Medical

Review Board and file a complaint against them before they would

approve it. The review board decided it was medically necessary and

that the insurance had to approve it.

Then the insurance did what yours did, approved it for 6 months with

the stipulation that they get to review it again after 6 months. It

took me over 6 months to get it approved the first time, I hope it

doesn't take another 6 months to get it re-approved.

Please let us know how it goes for you, and what you have to do to

get the insurance to cooperate. Can't blame you a bit for getting

mad. I'm still furious! Keep us posted. Thanks!

Annette

> so now, i am apparently waiting for the insurance committee to

again

> deam this medically necessary. am i crazy for feeling so mad? am i

> over-reacting?? is this a common thing, that after a few months,

the

> insurance companies feel the need to re-evaluate?

[Guest guest]

Our insurance requires a 6 month re-authorization. The last re-authorization was no problem, and there was no delay in getting the Xolair shots. We have to have another

authorization this month. I pray that the insurance company will continue paying, because my son now has a life! Since he has been on Xolair, there has not been any

emergency room or doctor visits. Bell <ecirun@...> wrote:

I haven't had to go through this, but I will. When I got the letter saying that my insurance had approved me, they said that it was for six months -- of course without any explanation of the criteria they'll use for renewal. So I was annoyed, and I'm sure that when the time comes I'll feel mad, so yes, I think you're perfectly justified in your reactions!

Now I'm worrying that I'm about halfway through the six month period and I'm not showing enough progress. I'm doing better, but my IgE count was 1100 at the initial test so it's going to take a while for the medicine to really work. My allergist said that my level was so high that I almost didn't get approved because the maximum dosage (which I currently receive) may not be enough for me. They can't retest IgE levels to determine renewal because the blood test cannot distinguish between free and bound IgE, so I'm not sure what criteria they'll be using. I'm afraid that my continued (but decreased) use of Advair and rescue inhaler will count as strikes against my renewal. I dunno.

I'm sorry you're in this situation also. I hope you don't have many more problems and wish I had advice for you, but please keep us posted. All I can tell you is that you aren't the only one who's going to have to do this.

heather <heaven1975@...> wrote:

thanks...my only thought right now is beat them silly with the empty xolair vials!!! > > i'm so irritated...i started xolair the end of january. about three > > weeks ago, my insurance decided that they needed to reauthorize it. > > so they fax the drs office, to which the drs office faxed > everything > > they requested back to them. i talked to the insurance and they > said > > on the 28th of may they received it, and was waiting to hear from > > curascript...apparently, the insurance has decided that they need > > more info, or just want to have it faxed again. curascript cannot

> > send my next shipment out (which i'm due for a shot next thursday) > > so now, i am apparently waiting for the insurance committee to > again > > deam this medically necessary. am i crazy for feeling so mad? am i > > over-reacting?? is this a common thing, that after a few months, > the > > insurance companies feel the need to re-evaluate? > > > > is it okay to post stuff like this here?? > > heather> > ,> > You bet! This is the place talk with others like you. I too use > Curascript, but my insurance company did not give me the run around.> Thank the Lord I have a good company that seems to actually CARE > about it's policy holders and their health.> > Honestly, I wonder if some insurance companies tell their employee's > to not pay a claim unless it is the very last resort.

These companies > could save money by not hiring so many employees to find loop holes > to deny claims.> > Hmmmmmmmmmm, that IS a thought!> > Doug

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