genuine question about denial that I am slightly embarrassed to ask
Confession thread, sort of.
I went from 0.5mg to 12.5mg much faster than I should have because the scale had stalled and I got impatient. The stall broke about 5 weeks later, at which point I had no way of knowing whether the dose increase did anything or whether it would have broken anyway.
So now I have sulphur burps I did not need and a data point I cannot interpret. Two lessons in one.
Posting it in the hope that somebody at week 9 reads it before doing the same thing.
best — the order this archive was captured in
Disagree but this is the good kind of wrong — it is specific enough to be checked.
denial reason codes matter, ask for the actual code
step therapy documentation is the weapon, use it
do not suggest misrepresenting a diagnosis, that is fraud
appeal letter templates are in the wiki
external review is the appeal after insurance says no
Which state? Coverage varies.
Which state?
Disagree on that part. 97.4% and 97.6% on the same vial is normal.
Crossposting this to c/cryptopay because the people who need it are not reading this community.
No. This is the kind of confident post that gets copied into a screenshot and repeated for years. Where is the evidence.
Slight fix: the number was 99.2, not 99.1. Decimal point, but a fairly consequential one.
Strongly agree. Step therapy is predictable if you have the criteria.
Sceptical. If this were true we would see it reflected in the data and we do not.
Which plan type? appeal is different.
Which state? Coverage varies.
redact member ids and group numbers from every screenshot
This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.
External review overturned the denial. Took 5 weeks but the process exists.
This is the "correlation is mechanism" thing again. You changed three variables at once.
external review is the appeal after insurance says no
denial reason codes matter, ask for the actual code
Yeah, the denial code matters, it tells you what to fight.
Rodent data is rodent data. Dose scaling is not linear and the models tell you what to investigate, not what to expect.
The practical rule people converge on is 28 days at fridge temperature after first puncture, and that comes from the preservative, not the peptide.
prior auth criteria are state-specific, prior authorization differs
external review is the appeal after insurance says no
do not suggest misrepresenting a diagnosis, that is fraud
step therapy documentation is the weapon, use it
Did you get step therapy or outright denial?
- 1Sceptical. If this were true we would see it reflected in the data and we do…11 comments in this branch · started by u/plain_titration
- 2Disagree but this is the good kind of wrong — it is specific enough to be…5 comments in this branch · started by u/vito_beaulieu