Case Study 2
Claim Summary:
An HSA Member with a chronic condition had an issue with prescription refill authorization. His medication was costing him $450/month.
Remediation:
- Obtained copy of member’s records and submitted documentation to carrier for urgent review on terms of medical necessity.
- Received approval from Medical Board and Medical Director
- Resubmitted all previous prescription claims
- Member met his deductible with submitted claim and received reimbursement