C10009605 / invoice 10000

O trying to process manual claim for visit on 02/02/26, had to wait until previous claim was processed so only doing now.Previous claim was processed with Gap Only which declined, but disputed it and Woolworths manually approved it.Now trying manual claim instead of the GapOnly first. O filling online claim which wants Hx attached. Advised we send hx directly to insurer so to reach out to them and they will send a hx request through.

FULL notes sent to Everyday insurance

Verified: YesClareHISTORYPresenting for: Bonnie presented for recheck of ear infection and pruritusHistorical Conditions:- Received 2 shots of Cytopoint in 2022-2023- History of chronic ear infectionsSkin:- Pruritus, especially after grooming- Not scratching as much since starting treatment with aopquelCurrent Meds:- Apoquel 5.4mg BID (day 7 of 10-day course)- Aurizon ear dropsEXAMMentation: BAREars: Mixed infection of Malassezia and bacteria still present bilaterally. Ears still appear inflamed despite treatment with Aurizon drops.Integumentary: Reduced pruritus compared to previous visitDiagnostics: Ear cytology - mixed infection of Malassezia and bacteria confirmedASSESSMENTOtitis externa - Mixed infection (Malassezia and bacteria based on ear cytology) present bilaterallyPruritus - Responding well to Apoquel therapyPLANMedications/Treatments:- Ears cleaned with saline in clinic- Long-acting Neptra ear medication (gel) applied in clinic - effective for 4 weeks- No ear drops to be used during this period- Groomer instructed not to touch earsChanges to Existing Meds/Tx:- Complete current Apoquel 5.4mg BID for remaining 3 days (total 10-day course)- Continue Apoquel 5.4mg SID for a few days after completing BID courseNew Meds/Tx:- Apoquel 16mg tablets dispensed (10 tablets) - client to administer 1/4 tablet (4mg) SID after completing current course- If pruritus worsens significantly before next appointment, may temporarily increase to 1/4 tablet BIDAdditional Discussion:- Insurance company declined coverage for Apoquel- Discussed using lower dose (4mg vs recommended 4.4-6mg) as more cost-effective option- Discussed that if quarter tablet daily is ineffective, will need to return to higher doseClient Comms:- Recheck ears in 5 weeks- Cost of treatment now approximately $75/month for apoquel including dispensing fee- Discussed option of prescription order online for future medication if current regimen effective3/2 NCB no answer mc