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c/insurancefights·submitted 8 months ago by u/marisol_moreau

external review is the most under-discussed thing in c/glp1muscle

Templatebranch of 6 comments

Week 78 update. 19kg down from the start, early fullness basically gone since about week 23. Things that worked: consistency, protein at breakfast, walking more than I want to. Things that did not: everything I bought on the internet to help with early fullness. The part that surprised me is how much of this is…

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6 comments, started 8 months ago
u/kasper_cabrera441 points·8 months ago

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

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u/marisol_moreauOP634 points·8 months ago

Which plan type? copay is different.

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u/ferritin_low195 points·8 months ago

Did you get step therapy or outright denial?

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u/plain_titration_202485 points·8 months ago·edited

say which country and which plan type

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u/muscle_cramp_mo68 points·8 months ago

Small correction: the trial was 4 weeks, not 23. Does not change your point but people will quote it.

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u/saskia_lokken159 points·8 months ago·edited

resubmission after denial requires new documentation

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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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