United HealthCare Services review: Prior authorization

My daughter was diagnosed with juvenile idiopathic arthritis four years ago, she was referred out from Phoenix Indian Medical Center to Phoenix Children's hospital and placed under the care of Dr. Elisha Wershba in Rheumatology, Dr. Wershba tried different medications which failed until she prescribed Actemra IV infusions at home. Imani received infusions until she became stable and pain free. In the beginning when first diagnosed she could barely walk through a grocery store without becoming upset and having to ride in the grocery cart to checkout and leave the store because she was in so much pain. Never at any point did her Dr. refer to pain management and being so young we thought maybe this was the right thing to do. After becoming stable she was removed from the medication because that was the goal of the medication to reset her system to make it work naturally on its own. 5-6 months later her symptoms came back worse than ever and she began missing a lot of school, suffering from chronic pain, inflammation, joint swelling, difficulty walking, and social and emotional problems because of it. 2 months ago Dr. Wershba ordered her to go back on the Actemra, our family had an insurance change which caused a lot of issues because we cannot seem to get a prior authorization for the medication. She originally was on Blue Cross Blue Shield who because we could not pay the premium would not give anyone confirmation that the plan had termed and she was no longer under their plan. Once that was finally resolved we thought things would begin progressing, Optum pharmacy for the past month and a half has been trying to get the prior authorization with no success, they began calling me about a month ago asking me to do their job and get a hold of the insurance, Phoenix Childrens, or do something to help, nobody seems to be on the same page, an example would be my calling Optum prior authorization department with Kristal Morgan on the line with who is from Optum Specialty Pharmacy, the representative on the line stated there was no prior auth in the system, Kristal explained to her that she had a case number etc, the representative reiterated to her that she could see nothing on her end. I had to filed another prior authorization to be submitted. When I called her new insurance United Health Care surest, they told me that her medication had been approved 100%, I called Kristal and notified her and I thought things would be taken care of, Kristal called me the next day and said this was not the case, I was very upset and asked to speak to someone in charge, nobody ever called me back. I have been repeatedly calling United Health care ,Phoenix Childrens and Optum Pharmacy, nobody seems to be on the same page and nobody seems to have any answers, somebody is not doing their job and my daughter is falling between the cracks and suffering mentally, physically, and emotionally due to this. Her rhuematologist would not prescribe her pain medication because she is 13 and they generally do not prescribe their patients opioids which is redundant because this is their job, they referred me back to her primary care physician who said she needed to be seen but it wasnt likely they would perscribe her anything, we took her to the emergency room where she has a history for this and they gave her percocet 5/325 for 3 days until she can get to her primary care doctor for further pain management. My complaint against Optum pharmacy is the simple fact that this whole process should never have been this hard, constantly reminding me how hard they are working on her behalf yet never having any answers as to what is going on, providing us with some transparency in being able to say, this is what happened, this is who screwed up, now we can learn from this and hopefully this does not happen to another child and we can do better, nothing has ever been done in that respect and its ridiculous, somebody needs to be held responsible for my daughter being almost a month and a half past her infusion date and it just being ok! It's not ok! I'm not looking for anyone to lose their job, but someone needs to be held accountable and reprimanded for their lack of knowledge as patient coordinators! I hope someone can get in contact with them and with us and provide us with some answers and relief!