u/niels_salinas

logs that stop 8 days get Concluded flair automatically

The confident tone is doing a lot of work that the evidence is not.

This is correct.

Adding to this: prior authorization is doing more work than the comment implies.

This is correct. Appeal letters work.

Has anyone actually got this in writing, or is it forum lore at this point?

This is correct. Appeal letters work.

public logs kept over 24 weeks and beyond

What are you comparing it against though?

Which state? Coverage varies.

Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.

External review overturned the denial. Took 22 weeks but the process exists.

Strongly agree. A1c matters as much as weight.

step therapy documentation is the weapon, use it

the 88 week mark is where it gets interesting

Slight fix: the number was 98.7, not 98.3. Decimal point, but a fairly consequential one.

What was the denial code?

the ALT change is the signal

no medication-stopping advice, ever

formulary exclusions are negotiable sometimes