Playing tag with Authorization
Hello all, thanks for reading and I apologize if I’ve done anything incorrectly, I’m not a big reddit user. I have Ulcerative Colitis and started Entyvio infusions earlier this year. BCBS of Arizona authorized my first 3 induction doses. After the induction doses, my doctor explained that they need to re-obtain authorization. Makes sense, they need to evaluate if the drug is working well before reauthorizing. But I had an infusion scheduled for today which was cancelled because my doctors were not able to get it authorized— BCBS said it is not their job to authorize, its a different third party (unfortunately I can’t remember their name!) So my doctors called that third party, and they said no, it’s BCBS’s job to authorize it. My doctors have been going back and forth for a few days and neither of these organizations are budging. I called BCBS myself to try to figure things out, and after trying to get information from a few more departments, he said he would call me back later. Unfortunately, I desperately need this infusion within a week. If I don’t, not only can I go back into an active flare, but the medication is unlikely to work again after taking an extended break. This is the first medication that has ever worked for me and has taken me out of an 11 year long flare. Has anyone encountered anything like this before? Is there ANYTHING I can do? I hate feeling so hopeless when my life is on the line and there is seemingly nothing I can do about it because neither group wants to take responsibility. Any insight or advice appreciated greatly!
