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c/insurancefights·submitted 1 year ago by u/hassan_castellanos

[Meta] proposal — a flair for prior authorization posts

Appealbranch of 4 comments

Something I noticed reading old threads that I have not seen said out loud. The advice on copay in this community changed substantially around the start of last year, and nobody went back and updated the older posts. So depending on which thread the search engine hands you, you get two contradictory answers with the…

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4 comments, started 1 year ago
u/niels_salinas23 points·1 year ago

What was the denial code?

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u/amara_haddad18 points·1 year ago·edited

resubmission after denial requires new documentation

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u/neha_rahimi6 points·1 year ago

What was the denial code?

Yes, exactly this, and it is the bit that took me 10 weeks to accept.

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u/neha_erdogan4 points·1 year ago

redact member ids and group numbers from every screenshot

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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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