step therapy is the most under-discussed thing in c/labresults
Quick one. Canada here.
prior authorization works very differently where I live than in the threads that dominate the front page, and I keep seeing people confidently given advice that simply does not apply outside the US.
Specifics: the route I used took 15 weeks and cost roughly what I expected. The admin was worse than the cost. The thing that would have saved me the most time was knowing which document to ask for at the start.
Happy to answer questions from anyone in the same jurisdiction.
best — the order this archive was captured in
This is the "correlation is mechanism" thing again. You changed three variables at once.
Retitled to remove editorialising. Put the evidence in the body.
Retitled to remove editorialising.
Disagree on that part. 99.2% and 98.9% on the same vial is normal.
Slight fix: the number was 98.7, not 98.3. Decimal point, but a fairly consequential one.
redact member ids and group numbers from every screenshot
external review is the appeal after insurance says no
Mechanistically the bit that matters is external review. It explains most of the early profile and a decent chunk of the outcome.
Yeah, the denial code matters, it tells you what to fight.
[removed by moderator]
Not to be pedantic but formulary and appeal are being used interchangeably and they are not interchangeable in real life.
I love that this community will spend 40 comments on a detail. That pedantry is why the numbers here matter.
I love that this community will spend 40 comments on a detail.
Disagree on that part. 93.7% and 99.3% on the same vial is normal.
formulary exclusions are negotiable sometimes
Strongly agree. Step therapy is predictable if you have the criteria.
Dead space in the needle hub holds a small but non-trivial volume. On low-volume draws that can be several units.
- 1This is the "correlation is mechanism" thing again. You changed three…5 comments in this branch · started by u/ireland_drugs_pay
- 2Mechanistically the bit that matters is external review. It explains most of…4 comments in this branch · started by u/karim_restrepo