Humana frequently denies Cialis prior authorizations due to missing information. Ensure your prescription includes complete patient demographics and a clearly stated medical diagnosis supporting Cialis use. Incomplete forms lead to delays and denials.
Medication Alternatives and Treatment Plans
Humana may require documentation demonstrating that less expensive alternatives were considered and deemed unsuitable. Provide detailed notes from your doctor explaining why other treatments are not appropriate for your specific condition and detailing the expected benefits of Cialis. Clearly outline the treatment plan including dosage and duration.
Insufficient Medical Documentation
Insufficient medical history or lack of evidence supporting the medical necessity of Cialis often results in denial. Submit thorough medical records, including lab results, previous treatment notes, and any relevant imaging studies. Clearly connect the medical evidence to the need for Cialis.
Prior Authorization Form Errors
Inaccuracies on the prior authorization form itself–missed fields, illegible handwriting, or incorrect patient information–can cause rejection. Carefully review and complete all sections accurately before submission. Double-check all data for mistakes.
Pre-existing Conditions
Certain pre-existing conditions may limit Cialis coverage under Humana plans. Consult your doctor and ensure your claim correctly addresses any potential conflicts with your health history. Provide clear explanation on how Cialis will mitigate specific risks.
