Prior Authorization Support
Lumen Pharmacy works directly with your office to resolve prior authorizations quickly, so your patients aren't left waiting at the counter. Here's exactly how we handle it — and a faster alternative for avoiding PAs altogether.
How We Resolve a Prior Authorization
Identify the Requirement
When a claim rejects for PA, our pharmacist reviews the rejection code and confirms exactly what the plan needs before it will pay.
Contact Your Office
We reach out by phone, fax, or e-prescribe portal with the rejection details, so the request moves forward without extra back-and-forth.
Gather Documentation
We help compile what plans typically require: diagnosis, prior therapies tried, relevant labs, and dosing rationale.
Submit the Request
We file through the plan's preferred channel — CoverMyMeds, Surescripts, a payer portal, or fax — so it's queued as soon as possible.
Track It to a Decision
Our team monitors status and follows up with the plan or your office if things stall, so nothing sits untouched.
Fill or Escalate
Approved requests are filled right away. If denied, we notify your office immediately and help evaluate an appeal or covered alternative.
Give Us the Chance to Share Formulary Preferences First
For many patients, we can avoid the prior authorization process entirely. Before a prescription is written, we can pull the patient's specific plan formulary, flag which alternatives are preferred or lower-tier, and share that with your office — so you can prescribe a covered option from the start.
- ✓Fewer delays — no multi-day approval cycle for the patient to wait through.
- ✓Lower cost to the patient — preferred-tier options usually mean a smaller copay.
- ✓Less work for your office — one quick formulary check instead of a full PA submission.
Have a Patient Who Needs a PA Resolved?
Reach our clinical team directly and we'll take it from there — status updates included.