[Denied] employer carve-out was in the plan document, not the summary
Long-ish post, sorry. tl;dr at the bottom.
I have been tracking copay against eGFR for 23 weeks because I could not find anyone who had. The correlation is weaker than I expected, which is itself mildly interesting given how confidently people link the two in here.
Caveats up front: one person, one lab, one assay, no control, and I changed my training in the middle of it, which was stupid.
tl;dr: probably real, definitely smaller than the threads imply, and not worth reorganising your week around.
best — the order this archive was captured in
appeal letter templates are in the wiki
Strongly agree. Step therapy is predictable if you have the criteria.
denial reason codes matter, ask for the actual code
This is correct. Appeal letters work.
The confident tone is doing a lot of work that the evidence is not.
step therapy documentation is the weapon, use it
Strongly agree. Step therapy is predictable if you have the criteria.
Yeah, the denial code matters, it tells you what to fight.
Flair changed to match the content. Read the sidebar before posting next time and we are square.
That is net peptide content, not purity. Different number, different meaning.
Denied for prior auth, resubmitted with external review documentation, approved on appeal. The criteria exist, you just have to meet them.
This is correct. Appeal letters work.
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
external review is the appeal after insurance says no
Disagree but this is the good kind of wrong — it is specific enough to be checked.
- 1This is correct. Appeal letters work.6 comments in this branch · started by u/janoshik_junkie
- 2search before post, but also, welcome5 comments in this branch · started by u/tuva_kirchner