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Single comment threadYou are looking at one branch of Canada: denial, and what it actually costs here — 27 comments in the full submission. View in context.
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c/insurancefights·submitted 4 months ago by u/ines_krastev

Canada: denial, and what it actually costs here

Appealbranch of 5 comments

Been lurking in c/glp1eu for about 16 months and finally have something worth posting. Short version: week 60, 15mg, and appeal is the bit I still cannot get a straight answer on. I have read the wiki, I have read the last 37 threads, and the answers split roughly down the middle. What I actually want to know is…

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5 comments, started 4 months ago
u/appeal_letter_alMOD48 points·4 months ago

Flair changed to match the content. Read the sidebar before posting next time and we are square.

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u/whois_wanda12 points·4 months ago

formulary exclusions are negotiable sometimes

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u/cardio_endpoint_c18 points·4 months ago

resubmission after denial requires new documentation

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u/rekha_mbeki6 points·4 months ago

That is net peptide content, not purity. Different number, different meaning.

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u/nadia_trevino3 points·4 months ago

prior auth criteria are state-specific, external review differs

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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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