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c/insurancefights·posted 10 months ago by u/jarno_adeyemi

is it normal to get nausea at week 44

Template Long Haul ×6 Cold Box ×1 Well Actually ×2

Something I noticed reading old threads that I have not seen said out loud.

The advice on prior authorization in this community changed substantially around the start of last year, and nobody went back and updated the older posts. So depending on which thread the search engine hands you, you get two contradictory answers with the same confidence.

I have listed what I think the current consensus is below. Correct me — that is the point of posting it.

4,971 up / 1,821 down73% upvoted11 commentsid 1e8khp15 Sep 2025

11 comments

7 in this archive, depth 3

best — the order this archive was captured in

u/edit_for_clarity232 points·10 months ago·edited

This is correct. Appeal letters work.

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u/elin_lindqvist114 points·10 months ago

Denied for prior auth, resubmitted with external review documentation, approved on appeal. The criteria exist, you just have to meet them.

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u/gustav_vermeulen136 points·10 months ago

Yeah, the denial code matters, it tells you what to fight.

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u/liv_kuipers84 points·10 months ago

What was the denial code?

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u/jarno_adeyemiOP99 points·10 months ago

Yeah, the denial code matters, it tells you what to fight.

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u/hamza_weiss23 points·10 months ago

Did you get step therapy or outright denial?

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u/janoshik_junkieindependent tester49 points·10 months ago

external review is the appeal after insurance says no

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About c/insurancefights

The paperwork war. Prior-authorisation criteria, denial reason codes, step-therapy documentation, external review, employer carve-outs, and the appeal letter templates the community has iterated on for three years. Mostly US-shaped but the tactics generalise.

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