formulary is the most under-discussed thing in c/coldchain
Something I noticed reading old threads that I have not seen said out loud. The advice on copay 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…
Denied for prior auth, resubmitted with external review documentation, approved on appeal. The criteria exist, you just have to meet them.
Retitled to remove editorialising. Put the evidence in the body.
prior auth criteria are state-specific, copay differs
appeal letter templates are in the wiki
No. This is the kind of confident post that gets copied into a screenshot and repeated for years. Where is the evidence.
Small correction: the trial was 3 weeks, not 27. Does not change your point but people will quote it.
do not suggest misrepresenting a diagnosis, that is fraud
Which plan type? prior authorization is different.