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UR Medication
#3
(10-28-2018, 01:56 PM)1171 Wrote: Are you aware of the rules using the new drug formulary that lists which drugs the state will allow?
The formulary is here
https://www.dir.ca.gov/dwc/MTUS/MTUS-Formulary.html
The rules are here
https://www.dir.ca.gov/dwc/DWCPropRegs/M...ations.pdf

Your atty should have a copy of every lien/ provider filed on your claim.
The board will also have a copy of the filed liens in your litigation folder.

Your physician can get pre approval.
Doctor refuses to write for any other medication besides this one. I was just curious how a UR happens for a med. Is it triggered automatically when I try and fill it? 
Sorry, I should have been more clear. I am trying to find a doctor that will accept a lien. I want to get treated elsewhere seeing as my doctor now will not refer me to an orthopedic surgeon and I have spinal stenosis. I was previously being treated by an orthopedic surgeon in California and moved. 
I have been seeing this doctor for a year and everything gets denied each month I go to him. Refuses to change treatment plan. His words are" If they don't like it, tough. This is my treatment plan and I will not deviate" and as you know UR's are binding for a year. He won't for example even change T3 facet block to a T4 facet block on paper(even though I need facet blocks in most my T spine). I said please refer me to an orthopedic surgeon like I was seeing in California and he goes "Why do you want to see an orthopedic surgeon, they won't be able to do anything for you" so I am stuck. Thanks for the med info, was more looking for how a UR is triggered. Do I have to call my attorney each time they deny the script at the pharmacy desk or is it done automatically
 
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Messages In This Thread
UR Medication - kibby - 10-28-2018, 11:47 AM
RE: UR Medication - 1171 - 10-28-2018, 01:56 PM
RE: UR Medication - kibby - 10-29-2018, 12:07 PM
RE: UR Medication - 1171 - 10-29-2018, 12:50 PM
RE: UR Medication - kibby - 10-29-2018, 01:15 PM
RE: UR Medication - California_Help - 10-29-2018, 09:16 PM

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