Pharmacy calls about approval

2026-10-02 3018 views 6 posts

Y'all, I am so tired of jumping through hoops. I dropped off my prescription at our little Main Street pharmacy on a Tuesday, and the pharmacist said the insurance wanted a prior authorization. That was five weeks ago.

I've called the insurance line three times, waited on hold 22, 35, and 47 minutes, and each person says it's 'in review.' Meanwhile the pharmacy tech, who knows me by name and my dog's name, keeps apologizing like it's her fault. I'm trying not to be ugly, but I've been doing my part: walking 20 minutes after supper, packing lunch instead of grabbing the diner special, and I'm down one jeans size.

I just want the paperwork to catch up.

Has anyone had luck asking the doctor's office to send the notes a second time, or is that just poking the bear?

Ugh, five weeks is criminal. Mine got stuck because the clinc sent the paperwork to the pharmacy’s old fax.

I only found out when I asked the tech for the fax confirmation sheet and the insurance reference number, then called insurance with both. Suddenly “in review” became “done.” Do you know if your doc’s office actually sent it, or is the pharmacy still waiting?

Also I’m over here eating dorm microwave rice + $1 tuna packets like a sad sushi chef, so solidarity.

Ugh, five weeks is ridiculous. Been there. The phrase “in review” can mean they’re waiting on the pharmacy to send chart

tbh sharp follow-up: have you asked insurance for a case/reference number, then called the pharmacy back with it? That’s the only thing that unstuck mine after weeks of hold music. Turns out the approval was sent to an old pharmacy address from two moves ago.

I’m a dorm rat with a mini fridge full of Greek yogurt, so I get the cheap-protein struggle—but phone tag is its own cardio. If they keep calling, ask exactly which fax/address they’re using. Sometimes it’s one digit off and everyone’s yelling into the void.

Five weeks is long enough that I’d stop calling the insurance line and ask the pharmacy for a printed status screen or fax confirmation—something with a reference number. There was a thread here a while back where the holdup was the insurer sending a form request to the prescriber’s office, not the pharmacy, and nobody told the patient.

Do you know if your clinic has one person who handles PAs, or is it whoever picks up the message? That’s the question that finally un-stuck mine.

I went through a version of this two summers ago—mine sat because the pharmacy had the script, but the PA got routed to some central intake queue. What finally moved it: I asked the pharmacy for the PA reference number and the fax/portal confirmation, then called insurance and asked them to read me the case notes.

Turned out they were waiting on one specific item nobody had told me about. Not saying that’s yours, but getting the reference number changed everything.

Also, keep a running note in your phone—dates, names, ref numbers. Sounds extra, but past threads swear by it, and it kept me from starting from zero every call.