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Floof96's Post

Floof96

Updated 1y ago

Insurance denying IBS-C medication

Hello, I have a bit of a dilemma. My insurance keeps denying my GI’s requests for Linzess because he won’t actually put on my record that I have IBS-C. He only suspects that I do, but wants me to have linzess because I keep having constipation. I tried to ask him to put it on my record, but he won’t right now. Any advice on what I should do? I’m super constipated

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AI-generated answer based on the text from previous posts and comments

One user mentioned that the doctor might be waiting to rule out anything serious before diagnosing, which could be why they are hesitant to put IBS-C on your record. It's important to communicate with...See More

chocolatetruffle

I would try asking your PCP about it/if they could prescribe it, perhaps? I'm surprised it's getting denied so many times, I imagine it wouldn't be that hard for him to explain why you need the medication, especially if he suspects ibs-c. There are also alternatives to linzess to try if it can't be approved.

Floof96

They give a reason of refusal for the prior-auth every time and the reason is “We did not see certain details about your use and treatment. We may consider approval for certain illness (IBS-C) or CIC. We did not see information that shows you have one of these illnesses.”

The content in this post is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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Insurance denying IBS-C medication

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