Pharmacy Initial Appeals Process
Progyny directly contracts reimbursement rates with pharmacies, and any changes to rates are communicated by the pharmacy to Progyny. Progyny’s initial appeals process is available for all prescription drugs or devices in Tennessee for which a pharmacy alleges it did not receive its actual cost. Pharmacies may contact:
- Sam Correll, SVP of Network Management:
- Vidhu Bhatnagar, Manager of Pharmacy Product, Network Management:
Pharmacies have up to 90 days from payment to submit an appeal and inquire about any discrepancies. Progyny does not have a standard appeals form. However, all requests must include the member’s name and date of birth, claim number and transaction number. Progyny does not assess fees for any services provided in connection with the initial appeal. All requests are resolved within 5 business days.