If your insurance company denies your child's medication, GPAM will perform the first prior authorization for the medication that you are prescribed. If an appeal is necessary to obtain a medication that your insurance company does not approve, there will be a $25.00 charge. If your first prior authorization is not approved, our doctors may write for another medication or a generic that you can substitute for the original prescription. Unfortunately insurance companies change their formulary without us being aware so we try to obtain the medications that your child is used to taking, but beware many times a prescription will have to be changed.