5 Apr, 2018 → by ClaimboUser106747
Prior approvals
I went to pick up my medication at pharmacy. I take it Daily and it’s needed you are not supposed to suddenly stop! It would not be refilled as I was told it needs a PA *Prior Approval* which needs to first come from the Dr., then go to Caremark and then to Tufts Health to approve. It’s been days I am hurting and nobody cares to help make this a priority. They stated sorry, the Dr. (Who is now away) did not write priority so it’s in a pile of faxes. We typically enter it within 24-48 hours and then it will go to Tufts for approval. This process is about 3 day’s! They tell me their fax is backlogged. It’s been days and they are closed over the weekend! Meanwhile, my Dr. went away and I’m feeling very sick at the fact they have not processed this fax!! It has been one of the worst experiences of my life. It would be nice if Tufts emailed you prior to when a “PA” is needed so you can obtain the Dr.’s form and have him send it before urgent medication is due. The entire PA system sucks, pay SO much money for this plan and I cannot even get my daily medication. Dr.’s hate doing these and there needs to be a faster system for ALL! He even stated I would be charged for his time faxing my PA!!! How is this FAIR?? Tufts Health would not even allow me to speak to a supervisor!