Our QuickfillRx experts will help you quickly and effectively resolve any prescription coverage denial. You don’t need to waste time learning complex insurance company rules — we’ll take control of the entire process and get results for you.
Why do Insurance Companies Deny Coverage?
One in five patients in the US faces insurance company denial for prescribed medications. According to a Kaiser Family Foundation (KFF, 2023) report, approximately 18% of all prescription requests are denied on the first attempt. Main reasons include:
- Medication not included in the formulary (list of covered drugs)
- Incorrectly filed documentation or missing necessary justification
- Prior authorization required but not provided
- Errors in data submission or insurance plan changes
Your Appeal Rights
Under the Affordable Care Act (ACA), every patient has the right to:
- File an internal appeal with the insurance company
- If denied — request an independent external review
Studies show that up to 60% of denials are overturned after filing a proper appeal (Government Accountability Office, GAO, 2022)
Step-by-Step Guide to Successful Appeals
1. Gather Documents
- Insurance company denial (explanation of benefits, EOB)
- Doctor’s prescription and medical indications
- Previous treatment history (if applicable)
2. Review Your Insurance Rules
Check if your medication is in the formulary and whether alternatives are available. This speeds up your argument process.
3. Write Your Appeal Letter
- Use clear and calm tone
- Explain why this specific medication is necessary (with medical arguments)
- Attach copies of all documents
4. Meet Deadlines
Insurance companies have set timeframes (usually 30-60 days). Missing deadlines is a common reason for denial even with correct arguments.
5. Contact QuickfillRx Experts
Our specialists process dozens of similar requests daily and know which language and documents give you the best chance of success.
How QuickfillRx helps you win on the first try
- We check formularies and find the optimal submission approach
- We prepare all documents and write proper appeal letters
- We monitor the process until completion — from submission to response
- We work directly with manufacturers to connect additional assistance programs (co-pay, manufacturer assistance)
Common Patient Mistakes
- Sending incomplete document packages
- Ignoring deadlines
- Using emotional arguments instead of medical ones
- Attempting to file complaints without consulting a pharmacist or attorney
Real Results
According to our internal analysis (QuickfillRx, 2024):
- 84% of patients who contacted us for appeal assistance received medication approval after the first submission
- On average, the process takes 7-10 business days instead of the typical 30-45 days for self-filed appeals
A prescription coverage denial is not a final verdict. With the right approach and support from QuickfillRx specialists, most denials can be overturned.
Call us today — and we’ll handle all the bureaucracy so you can focus on your health.