A claim for medication may be denied for several reasons:
1. It may be that information was entered incorrectly (name spelling, incorrect birthday or identification number)
2. The claim is not a covered expense under your plan
3. The claim may be eligible but not able to be direct billed due to the nature of the medication
4. Some medications may also require special approval or more information may be required to support your claim, such as a physician's note or treatment plan.
5. It was denied in error
Please review your explanation of benefits provided by the insurance Carrier for the reason your claim was denied. If you think that your claim(s) has been denied in error, you or your pharmacist can reach out directly to your employee group benefits team at claimssupport@sterlingcapitalbrokers.com.