[Canada] Ontario sourcing - todays discussion

ontario too. The stock gaps were annoying but what actually stalled me was the plan changing its mind mid year, so I get the paperwork headache more than the sourcing one

What finally moved things for me was calling my plan directly and asking which specific code they wanted on the form, because my clinic had been guessing.

Not in Ontario, I'm in OKC, but the mid-month stock thing you mentioned happens here too. I've started calling around the first week, which is annoying but beats driving to three pharmacies.

What finally worked for me was asking my insurer for the actual prior-auth criteria in writing before my doc resubmitted, so the note hit the right points the first time

Not in Ontario but the coverage angle is what got me. My first claim got denied and I only sorted it out after calling the insurer straight instead of letting the pharmacy run it, so that part of the thread rings true even down here.

ontario too, and the first-week-of-month calling thing has been my routine as well. Curious whether you're going through a pharmacy or one of the online clinics for the prescription side?

I'm in Ontario too and still waiting on my first claim to come back, so the prior-auth comments here are useful to hear. Did yours go through on the first resubmission or did it take a couple tries

which pharmacy delivery day did you land on? Mine only gets stock Tuesdays, so I've shifted my whole refill routine around that.

Do you find the coverage paperwork varies a lot by pharmacy chain? Mine handled the prior auth for me, but I've heard others had to chase it themselves.

Do you find the delivery-day thing varies by pharmacy chain? My shoppers run is hit or miss on the day I ask about.

I'm in Ontario too and the shipment-day trick has been the one thing that actually cut down my running around. My own coverage runaround took two appeals before anything moved, so I get why the sourcing side feels heavier than the loss itself

Curious how the appeal actually went for you, did they give a reason the first claim got denied or was it just a no with no explanation

tbh not in Ontario but the delivery day trick works down here too. I just ask my guy what morning the truck comes and pick it up that afternoon, way less phoning around.

idk, not in Ontario but the delivery-day trick is what saved me too. I just asked my pharmacy which morning their truck lands and now I time my refill request around that instead of calling every few days

Curious whether anyone here has actually gotten a straight answer from their plan on the criteria, or is it just me getting the runaround. I've been at this about a month and the paperwork is already wearing me down more than the meds.

Ontario too. I stopped chasing every pharmacy in town and just asked my one regular spot which day their order lands, so now I know when to call instead of guessing.

What weekday do your shipments land, and did you have to call around much to find that out? I'm still bouncing between two pharmacies here in Ontario.

San Antonio here so no Ontario pharmacy drama, but the part about getting the denial reasons in writing is what finally moved my plan along too. Did they give you a specific criteria list or just the vague "not medically necessary" line?

which pharmacy chain actually flags you when stock lands? I've been calling around cold and getting nowhere

Curious whether anyone here has tried the smaller independent pharmacies instead of the big chains, mine actually calls me before my dose runs out