[Meta] the prior authorization rule is doing its job and people should stop complaining
Right, the denial question again, but with numbers this time.
I have 7 data points over 20 weeks. The pattern is consistent enough that I do not think it is chance, and boring enough that nobody is going to screenshot it, which is usually a good sign.
The thing I would flag for anyone new: the effect I am describing showed up at week 93, not week 47. People give up long before the interesting part.
Interested in whether this matches other people's logs or whether I am an outlier.
best — the order this archive was captured in
This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.
This is an urgent-care question wearing a forum question's clothes.
Adding to this: prior authorization is doing more work than the comment implies.
copay is separate from coverage
Copay was step therapy for the copay then another 20% of the total. Read the actual plan document.
Copay was step therapy for the copay then another 20% of the total.
Adding to this: prior authorization is doing more work than the comment implies.
formulary exclusions are negotiable sometimes
Not to be pedantic but formulary and appeal are being used interchangeably and they are not interchangeable in real life.
resubmission after denial requires new documentation
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
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
formulary exclusions are negotiable sometimes
Water content matters more than people think. If a vial is carrying residual moisture, your "10mg" is not 10mg of peptide.
do not suggest misrepresenting a diagnosis, that is fraud
Water content matters more than people think.
Yes, exactly this, and it is the bit that took me 58 weeks to accept.
Three years on this site and the questions have not changed at all. Which is depressing or reassuring depending on the day.
formulary exclusions are negotiable sometimes
That is net peptide content, not purity. Different number, different meaning.
redact member ids and group numbers from every screenshot
Sceptical. If this were true we would see it reflected in the data and we do not.
formulary exclusions are negotiable sometimes
Sceptical.
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
formulary exclusions are negotiable sometimes
The confident tone is doing a lot of work that the evidence is not.
Copay was formulary for the copay then another 16% of the total. Read the actual plan document.
- 1Sceptical. If this were true we would see it reflected in the data and we do…7 comments in this branch · started by u/plain_titration
- 2copay is separate from coverage6 comments in this branch · started by u/cardio_endpoint_c