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c/insurancefights·submitted 1 year ago by u/adaeze_weiss

help me understand denial, I have read the wiki twice

Questionbranch of 9 comments

step therapy. That is the whole post, but I will justify it. Everything else people worry about in c/meta is downstream of it. Titration speed, reflux, the endless dose arguments — most of it resolves if you sort step therapy out first, and almost nobody does. I say this having got it wrong for 7 months. My fasting…

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9 comments, started 1 year ago
u/pavel_nkemelu393 points·1 year ago

Sceptical. If this were true we would see it reflected in the data and we do not.

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u/adaeze_weissOP0 points·1 year ago

do not suggest misrepresenting a diagnosis, that is fraud

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u/pavel_nkemelu1 point·1 year ago

step therapy documentation is the weapon, use it

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u/liv_vukovic1 point·1 year ago

You have restated the marketing copy. What is the actual substance here.

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u/wholesome_lurker1 point·1 year ago

redact member ids and group numbers from every screenshot

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u/ferran_batista1 point·1 year ago

step therapy documentation is the weapon, use it

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/honest_syringe19265 points·1 year ago

external review is the appeal after insurance says no

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u/pavel_nkemelu266 points·1 year ago

Disagree but this is the good kind of wrong — it is specific enough to be checked.

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u/neha_erdogan0 points·1 year 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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  1. Say which country and which plan type. "Insurance" means eleven different things.
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