I recently had a prior authorization for nuvigil for shift work disorder that was denied, my psych wrote the script for 250mg pills assuming it would be denied (funny he didnt mention prior auth til I ask about it) so I could buy less pills and split them instead of writing it for 150mg which is the approved dose for shift work disorder. When I called to find out why I was denied considering I had a correct diagnosis but the rude cvs caremark person who took my call said I dont have narcolepsy and didnt explain anything else. Could the denial of been caused due to the dosage difference and the insurance guy didnt want to tell me that?
Its probably because of that dose requiring a narcolepsy diagnosis. If he ordered the correct dose they might authorize it. Insurance are slick these days, they'll find all kinds of little things that help them save all their money.
Generally, once you have prior authorization the doctor can increase the dosage without much problem, at least that is my experience. But since it was denied, I suspect it is because of the diagnosis. Strange though because Nuvigil is approved for shift work disorder. I would appeal the insurance company decision. Time is of the essence though because they only allow so much time from denial to file an appeal.
- Nuvigil Information for Consumers
- Nuvigil Information for Healthcare Professionals (includes dosage details)
- Side Effects of Nuvigil (detailed)
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