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

step therapy — my 7-week log, condensed into one table

Questionbranch of 6 comments

I have had 9 orders now and I keep a table, so here is the honest summary rather than a vibe. Material has been consistent. Communication has not. Shipping has varied by about 32 days on nominally the same lane, which matters more in summer than in February. The independent number came back 93.7% against a claimed…

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6 comments, started 1 year ago
u/oskar_kaufmann447 points·1 year ago
n=1 but same
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u/hamza_weiss102 points·1 year ago·edited

copay is separate from coverage

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u/ignacio_vanheckeOP56 points·1 year ago

The confident tone is doing a lot of work that the evidence is not.

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u/neha_erdogan0 points·1 year ago

do not suggest misrepresenting a diagnosis, that is fraud

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u/sofia_ferreira73 points·1 year ago

say which country and which plan type

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u/ignacio_vanheckeOP62 points·1 year ago

Strongly agree. Step therapy is predictable if you have the criteria.

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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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