three years of appeal threads, summarised so you do not have to read them. I have gone back and forth on this for months. Kept a log with every date, name of department…
c/insurancefights — hot, page 3
Positions 51–75 of 95.
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…
why does nobody talk about formulary — that is what I am asking, and I have already read the wiki twice. External review, which is the most underused mechanism…
Posting this as a discussion rather than a claim: the copay thing finally clicked for me and I want to write it down. Why step therapy denials feel unfair and are…
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glbiochem.netcopay — what am I missing here. If this has been answered properly somewhere, link me and I will delete. A peer-to-peer conversation puts the prescribing clinician in…
why does nobody talk about step therapy. Searched first, found three threads that contradict each other, hence the post. Step therapy requires documented trial of…
the step therapy question that gets asked weekly, answered properly, and I am aware this is a minority view on this board. Kept a log with every date, name of…
why does nobody talk about copay, and I want the answer with the reasoning attached rather than just the conclusion. Kept a log with every date, name of department and…
Genuine question, and the title is the question: appeal — what am I missing here. Spent six weeks arguing in general terms and got nowhere. Two paragraphs quoting their…
the prior authorization question that gets asked weekly, answered properly, and I am aware this is a minority view on this board. Internal appeals are decided by the…
the appeal advice in here is 2 years out of date, which sounds obvious until you try to state the evidence for it. Pulling the figures out of the title: 2 years. All of…
proposal — a flair for appeal posts. This affects how posts get sorted and removed, so it belongs in the open. Asked for the policy bulletin by number and wrote the…
The title is the whole question — genuine question about denial that I am slightly embarrassed to ask — but here is why I am asking. Prior authorisation criteria are…
France: appeal, and what it actually costs here, which sounds obvious until you try to state the evidence for it. New plan year, entirely new criteria, and the denial…
the appeal advice in here is 3 years out of date. It is the sort of thing everyone half-believes and nobody writes down. The numbers the title promised, since a…
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Browse resultsThe title is the argument: the step therapy thing finally clicked for me and I want to write it down. Here is the rest of it. New plan year, entirely new criteria, and…
how much of what we believe about appeal actually comes from step therapy threads. Searched first, found three threads that contradict each other, hence the post. Asked…
reading prior authorization threads from 2024 and half of it aged badly, which sounds obvious until you try to state the evidence for it. Prior authorisation criteria…
the denial advice in here is 3 years out of date, and I am aware this is a minority view on this board. 3 years — those are the numbers, and they are the ones I am…
the formulary advice in here is 3 years out of date. Making the case below, and I expect to lose some of it in the comments. Figures up front so nobody has to dig: 3…
the appeal thing finally clicked for me and I want to write it down. Not a hot take, just something I have not seen said plainly here. Step therapy requires documented…
Germany: external review, and what it actually costs here — a position I have arrived at slowly and would like tested. Employer-sponsored plans may be regulated…
can we stop arguing about appeal until somebody posts a number — that is what I am asking, and I have already read the wiki twice. External review, which is the most…
step therapy is the most under-discussed thing on this board. It is the sort of thing everyone half-believes and nobody writes down. External review was the thing that…
appeal — 4 things I got wrong before I got it right — a position I have arrived at slowly and would like tested. Missed a deadline because I counted from when I opened…