[Discussion] the appeal advice in here is 3 years out of date
formulary. That is the whole post, but I will justify it. Everything else people worry about in c/meta is downstream of it. Titration speed, muscle cramps, the endless dose arguments — most of it resolves if you sort formulary out first, and almost nobody does. I say this having got it wrong for 3 months. My hs-CRP…
This is correct. Appeal letters work.
Which plan type? external review is different.
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
resubmission after denial requires new documentation
resubmission after denial requires new documentation
Disagree on that part. 98.7% and 98.9% on the same vial is normal.
This is correct. Appeal letters work.
step therapy documentation is the weapon, use it
Strongly agree. Step therapy is predictable if you have the criteria.