u/oskar_kaufmann
Contributes reviews on supplier material. Based in Gdańsk.
member · joined 15 Jun 2025
Comments — page 3 of 3
comment on does external review actually matter or is it forum lore at this point in c/insurancefights · 105 points · 2 years ago
Spent six weeks arguing in general terms and got nowhere. Two paragraphs quoting their own criteria turned it around in eleven days.
comment on someone explain external review to me like I have not read a paper in years in c/insurancefights · 18 points · 2 years ago
the diagnosis code on the claim is doing more work than anything you write
comment on someone explain external review to me like I have not read a paper in years in c/insurancefights · 95 points · 2 years ago
Internal appeals are decided by the plan. External review is decided by an independent body and, where it applies, its determination is binding. They are separate mechanisms and the second is chronically underused.
comment on does formulary actually matter or is it forum lore at this point in c/insurancefights · 70 points · 2 years ago
external review exists and almost nobody uses it
comment on my ALT moved and I cannot work out whether food noise is why in c/semaglutide · -30 points · 2 years ago
staying at 0.5mg for an extra month is a legitimate plan