10/22/2026
Let's Talk Biologics!
We treat certain chronic skin conditions with advanced medications called biologics. These medications can be life-changing for patients, but getting them into your hands isn't simple!
In fact, sometimes getting the medication approved is half the battle! 😅
So, what happens behind the scenes? 👀
🩺 Step 1: Provider Recommends Treatment
Your provider determines that a biologic may be the best option for your condition. Sounds simple enough, right? Well... here comes the paperwork!
📋 Step 2: The Insurance Battle Begins
Most insurance companies require something called a prior authorization. This means we have to provide medical records, document treatments you've already tried, and explain WHY this medication is medically necessary.
And sometimes, even after all of that, insurance says DENIED. 🙃
But we don't stop there! We may submit appeals, provide additional documentation, or request further reviews. This can take WEEKS. 😩
💰 Step 3: Finding Financial Assistance
Even with insurance approval, biologics are expensive! Our team works to identify available copay assistance / patient assistance programs. These programs have their own applications, requirements, and processing times.
📦 Step 4: The Specialty Pharmacy
Unlike your typical prescriptions, biologics are usually filled through specialty pharmacies. MOST times your insurance even decides WHICH specialty pharmacy you're required to use! Once we have this information, shipment can be set up between patient and pharmacy! 😄
✨Here's what we want our patients to know:
When you're waiting on your biologic, please know that our team is working behind the scenes. We're making phone calls, submitting paperwork, communicating with insurance companies, coordinating with pharmacies, and exploring assistance options.
We understand how frustrating it can be to wait for treatment when you're dealing with an uncomfortable or painful skin condition. We want you to feel better just as much as you do!
At Glass Dermatology, patient care doesn't stop when you leave the exam room. 💗
