Amber Specialty Pharmacy will assist you in initiating the PA process with your patient's insurance company. We will initiate the request through an ePA system, send you a paper prior authorization form or send/call you with the steps your patient's insurance company requires to complete the PA process.
Please call us at 888-370-1724 if you have any questions or concerns. We want to take as much of the administrative burden off your hands as possible, so you can focus on your patients.
Amber Specialty Pharmacy will call, fax or email you when a prior authorization is needed on a medication for a patient. If you have a preferred method of contact or specific person in your office you would like us to contact in regards to prior authorizations, please call us at 888-370-1724 to let us know.
Does the pharmacy handle the prior authorization process, or do we at the doctor's office need to submit the PA?
We will initiate the prior authorization (if the insurance allows), but most payers require the medical doctor's office (MDO) to sign off on the authorization and submit it. If a patient placed an order for a medication and then faces delays with the prior authorization, we will reach out to the patient to let them know about the delay.
Amber Specialty Pharmacy is a preferred specialty pharmacy provider for many networks and is able to fill for most insurance plans. As part of our benefits investigation, we call each plan and verify whether or not the patient is locked into filling at a specific specialty pharmacy. Plainly put: Just because our name isn't on the back of an insurance card doesn't mean we cannot fill for a patient. Amber Specialty Pharmacy will fully analyze and seek permission to fill for all insurance plans. We are also a fully licensed Medicare facility with access to 41 state Medicaid FFS plans. To find out if Amber Specialty Pharmacy can care for your patient, call, email or fax escribe with patient information, and our Intake Specialists will answer all your questions.
What if you can't fill for a patient? Do you triage to another pharmacy if you can't take the insurance?
Some insurance policies require patients fill their prescriptions at a specialty pharmacy dictated by the policy. We will clarify any such requirements with the plan and will obtain any available details regarding exceptions or permission to fill at Amber Specialty Pharmacy. In the event that we cannot fill for a patient due to insurance restrictions, we will notify prescribers. Then, we will transfer and triage the patient to their required specialty pharmacy if the receiving pharmacy accepts the transfer.
In the event we cannot fill for a patient because we do not have access to a limited distribution drug, we will notify the prescriber of the names of the pharmacies that do have access. We will then transfer and triage the patient and prescription to prescriber's chosen pharmacy.
In 2019 we were able to secure $42 million dollars for our patients through grants, foundations and copay assistance. While we can't guarantee total coverage for every patient, we have a team that works with patients to help them discover additional aid.