Prior authorization is one of the most frustrating parts of getting a specialty medication approved. Here's how the process works — and how our team takes it off your plate.
Prior authorization (PA) is a requirement from your insurance company that your prescribing physician must obtain approval before your plan will cover a specific medication. For specialty drugs — which can cost tens of thousands of dollars per year — this process is nearly universal and can be one of the biggest sources of delay and stress for patients.
At Sorrento, we work closely alongside your provider to help make the prior authorization process as smooth and fast as possible — so your therapy can start without unnecessary delays.
Insurance companies use prior authorization as a cost-control measure, ensuring that a medication is medically necessary for your specific condition before agreeing to cover it. For specialty drugs, insurers apply particularly rigorous requirements — including clinical documentation, step therapy protocols, and periodic re-authorization throughout your treatment.
Denials can happen for many reasons: missing documentation, a medication not being on the preferred drug list, or a requirement to try a less expensive alternative first — called "step therapy." In 2026, these requirements have tightened significantly across most major insurers. But a denial is not the end of the road — your provider can follow up, request a peer-to-peer review, or submit an appeal with additional clinical support.
While prior authorizations are initiated and led by your prescribing physician, our team is here to help every step of the way. We communicate proactively with your provider's office to make sure they have the information and documentation they need, alert them promptly if anything is missing or if a follow-up is required, and keep you informed on the status so nothing falls through the cracks. Think of us as a support system working in the background to help your doctor get you approved as quickly as possible.
Make sure your doctor's office is aware that you're filling your prescription with Sorrento and has our fax number (818) 279-2540 on file. Respond promptly if we or your provider's office reach out for additional information. And keep your insurance card and member ID handy when you first contact us — the more complete the picture we have upfront, the faster your provider can move through the approval process.
Don't panic. Your physician has the right to request a peer-to-peer review with the insurance company's medical director, submit additional clinical documentation, or file a formal appeal. Our team will keep you and your provider informed throughout this process and help ensure your physician has everything they need to advocate effectively on your behalf. We can also explore whether alternative medications in the same class might have an easier path to approval, or identify manufacturer assistance programs that could help bridge any gap in coverage.
Our team serves patients throughout California with specialty medications, prior authorizations, financial assistance, and free delivery right to your door.
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