[Discussion] denial is doing more work than we give it credit for
Something I keep coming back to: denial is doing more work than we give it credit for. Documented eighteen months of what had been tried in a one-page table. That table was the appeal. External review, which is the most underused mechanism discussed on this board. Internal appeals are decided by the plan. External…
keep every date, every reference number, every name of a department
Yes. Written, always, even when they tell you a phone call is sufficient.
What is the appeal deadline on the letter?
Has a peer-to-peer been offered or requested?
the denial letter names the criterion, start there
Careful — the deadline runs from the date on the letter. Waiting for a call back can cost you the appeal entirely.
Left up. It carries dates, a criterion and an outcome, which is what makes these threads useful.
the second-level appeal is where things actually turn
a peer-to-peer call is often faster than a written appeal