unpopular opinion: formulary is massively overrated
Trying to settle this properly because the thread from last year went in circles. The claim: formulary matters. The counter-claim: it is measurement error. Both sides have been asserting it confidently for about 11 months without either producing anything. What would actually settle it is 7 people measuring the same…
I am going to push back on this slightly.
I am going to push back on this slightly.
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
step therapy documentation is the weapon, use it
Ireland plan: step therapy required 12 medications first. Did them all, got approval. The order matters.
This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.
Disagree. What you are describing is consistent with copay, not with what you concluded.
Strongly agree. Step therapy is predictable if you have the criteria.
resubmission after denial requires new documentation
This is an urgent-care question wearing a forum question's clothes.
Adding to this: appeal is doing more work than the comment implies.
resubmission after denial requires new documentation