Nurtec denial. Doc won’t return calls to help with appeal.

I'm trying to help my 25 year old daughter with an insurance appeal. She has had severe migraines since childhood and has tried virtually every available medication as well as numerous lifestyle modifications, and nothjing works well. Recently, her neurologist has prescribed Nurtec as treatment (not preventative) and my daughter has found it to work well at stopping a migraine.

Unfortunately, her insurer, Ambetter From Peach State, has denied coverage for Nurtec. It is very expensive. I have told her to get her neurologist involved, but so far the neurologist has not returned any phone calls.

I am wondering if it of any use for my daughter to do the appeal herself, without any backup from the doc. Seems like the insurer would not be inclined to take the patient's claim of necessity too seriously.

Also, is there any procedure we're missing for getting help from the neurologist on this? Should she make an appointment, and bring it up there? Thanks.

submitted by /u/GDK_ATL
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