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Floof96

442d

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

    • chocolatetruffle

      439d

      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

        439d

        @chocolatetruffle 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.”

☝ This content is generated by our users and it is not a substitute for professional medical advice. Please consult with your physician before making any medical decision

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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 your doctor about your concerns and discuss alternative treatments for constipation if Linzess is not an option due to insurance issues.

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