In general, Alpha does not submit appeals for unfavorable Prior Authorization determinations. This is why we encourage patients to provide all pertinent information on past medications tried, side effects or intolerances experienced, and relevant medical conditions up front. Decisions to submit a Prior Authorization appeal may be handled on a case-by-case basis depending on extenuating circumstances.
We understand that a Prior Authorization denial is disappointing. Our Alpha providers are happy to work with you to explore alternative treatment options that may be covered by your insurance or that may have more affordable out-of-pocket prices.