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the copay question that gets asked weekly, answered properly
Long-ish post, sorry. tl;dr at the bottom. I have been tracking denial against eGFR for 21 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,…
This is correct. Appeal letters work.
step therapy documentation is the weapon, use it
formulary exclusions are negotiable sometimes
External review overturned the denial. Took 16 weeks but the process exists.
prior auth criteria are state-specific, copay differs
Sceptical. If this were true we would see it reflected in the data and we do not.
[deleted]41 points·10 months ago
[deleted]
resubmission after denial requires new documentation