[Question] does the copay card stack with anything or is that a myth
does the copay card stack with anything or is that a myth — that is what I am asking, and I have already read the wiki twice. External review, which is the most underused mechanism discussed on this board. Internal appeals are decided by the plan. External review sends the determination to an independent body. Where…
Prior authorisation criteria are republished each plan year. A criterion that blocked you in one year may not exist in the next, so a denial is worth retesting after the turnover.
Prior authorisation criteria are republished each plan year.
Disagreeing with this line: the deadline runs from the letter date and treating it otherwise is expensive.
the second-level appeal is where things actually turn
the second-level appeal is where things actually turn
Agreed — and request the bulletin by number. They have to give it to you.
Correction: that is a formulary exclusion, not a prior authorisation denial. Different form, different route, different deadline.
appeal in writing even when they say a call is enough
Peer-to-peer took fifteen minutes and resolved something a written appeal had been sitting on for a month.