How to Reduce Prior Authorization Delays for GLP-1s

When submitting a prior authorization for GLP-1s, the outcome can feel out of your hands. But there are ways for clinicians to prevent delays and denials — and usually that means having a process in place from the start.

Let’s discuss how to make the prior authorization process for GLP-1s faster and smoother for you and your patient.

Build the prior authorization the right way

The No. 1 reason prior authorizations for GLP-1s get denied is because of missing information. That’s why it’s important to make sure you have all of the information required by the patient’s insurance plan before starting the prior authorization.

This information can include:

• Lab results

• Chart notes

• Additional patient requirements, such as joining an approved weight-loss program

Remember: Submitting early isn’t the same as submitting ready.

Someone needs to own the process

Practicing clinicians know that when something is everyone’s responsibility, it often ends up being no one’s responsibility. This is how deadlines get missed and delays occur. That’s why having a designated person owning the prior authorization process is so key to avoiding delays. 

A point person can track deadlines, monitor requests for additional information, and respond quickly. 

Treat denials like road maps

A prior authorization denial can feel like a frustrating setback. But keep in mind that the first denial isn’t the end of the road. 

In your appeal, you can use a denial like a road map. Review the denial reasons carefully and refute them point by point. Remember, successful appeals are specific and unemotional.

Appeals also have hard deadlines. So it’s important to be thorough, but to work with urgency.

Approval isn’t the finish line

Filing a successful prior authorization is a crucial step, but that work only matters if the medication ends up in the patient’s hands. Keep the patient updated on the status of their prior authorization and inform the pharmacy too. Do a final check to make sure the prescription is written accurately so your patient can pick it up without delay. 

Taking these steps can help prevent approved prescriptions from sitting unfilled.