[Vendor] WXT order #9 — the Netherlands, 33 days, no drama, receipts inside
Been lurking in c/cryptopay for about 12 months and finally have something worth posting.
Short version: week 39, 2.4mg, and appeal is the bit I still cannot get a straight answer on. I have read the wiki, I have read the last 23 threads, and the answers split roughly down the middle.
What I actually want to know is whether the people saying it does not matter have measured it, or whether it is just repeated confidently. Happy to be told I am overthinking this — I probably am — but I would rather overthink it now than at week 33.
best — the order this archive was captured in
Removed a chain here. The rule is one line long and it is not negotiable.
denial reason codes matter, ask for the actual code
Copay was formulary for the copay then another 2% of the total. Read the actual plan document.
External review overturned the denial. Took 7 weeks but the process exists.
Disagree but this is the good kind of wrong — it is specific enough to be checked.
formulary exclusions are negotiable sometimes
formulary exclusions are negotiable sometimes
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
Respectfully this is a sample of one presented as a finding.
resubmission after denial requires new documentation
resubmission after denial requires new documentation
Disagree on that part. 98.4% and 98.3% on the same vial is normal.
external review is the appeal after insurance says no
do not suggest misrepresenting a diagnosis, that is fraud
What was the denial code?
Strongly agree. Step therapy is predictable if you have the criteria.
appeal letter templates are in the wiki
Half-life is about 168 hours, so steady state lands around week 2–5. Practical consequence: what you feel in week 1 is not what that dose does.
External review overturned the denial. Took 4 weeks but the process exists.
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
appeal letter templates are in the wiki
appeal letter templates are in the wiki
Adding to this: prior authorization is doing more work than the comment implies.
Disagree. What you are describing is consistent with external review, not with what you concluded.
say which country and which plan type
external review is the appeal after insurance says no
Disagree.
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
formulary exclusions are negotiable sometimes
Strongly agree. Step therapy is predictable if you have the criteria.
- 1Half-life is about 168 hours, so steady state lands around week 2–5.…10 comments in this branch · started by u/wholesome_lurker
- 2Removed a chain here. The rule is one line long and it is not negotiable.7 comments in this branch · started by u/appeal_letter_al