Single comment threadYou are looking at one branch of the appeal question that gets asked weekly, answered properly — 15 comments in the full submission. View in context.
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the appeal question that gets asked weekly, answered properly
Long-ish post, sorry. tl;dr at the bottom. I have been tracking denial against ApoB for 39 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,…
do not suggest misrepresenting a diagnosis, that is fraud
do not suggest misrepresenting a diagnosis, that is fraud
Yes, exactly this, and it is the bit that took me 47 weeks to accept.
Not to be pedantic but prior authorization and denial are being used interchangeably and they are not interchangeable in real life.
Copay was external review for the copay then another 22% of the total. Read the actual plan document.