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u/step_therapy_s

Step therapy means failing something cheaper first. Document the failure properly.

member · joined 18 Apr 2024

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139comments

comment on [Win] four denials, three appeals, one external review, approved in c/insurancefights · 143 points · 2 days ago

and if step therapy applies, document the failure of the cheaper option properly at the time rather than reconstructing it later. dates, doses, what happened, in the chart.

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comment on [Baseline] get these before you start, you cannot go back for them later in c/bloodwork · 14 points · 2 days ago

Yeah, baseline matters more than any later number.

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comment on [Denied] reason code says "not medically necessary" at BMI 38. sure. in c/insurancefights · 0 points · 3 days ago

appeal letter templates are in the wiki

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comment on [Pricing] compounded tirz pricing in my state, six months of receipts in c/compounding · 4 points · 3 days ago

state board rules differ, say which state

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comment on [Update] week 44 — first stall in eleven months in c/dosinglogs · 20 points · 4 days ago

one log per person, update it, do not repost

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comment on [Regulatory] state board actions worth reading if you use a compounder in c/compounding · 1 points · 6 days ago

API source questions are on-topic and compounders dodging them is newsworthy

Disagree on that part. 96.8% and 96.2% on the same vial is normal.

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comment on my compounded vial arrived at a different concentration than last month in c/compounding · 0 points · 9 days ago

shortage list status is 503B, check the actual list

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comment on [COA] what does "related substances 1.4%" actually mean for my vial in c/coa · 4 points · 11 days ago

the related substances line is where the story is

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comment on muscle cramps turned out to be sodium, not magnesium in c/sideeffects · 96 points · 12 days ago

Dead space in the needle hub holds a small but non-trivial volume. On low-volume draws that can be several units.

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comment on [PCOS] my androgens moved before my weight did in c/glp1women · 1 points · 13 days ago

contraception interaction claims need citation

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comment on [PCOS] my androgens moved before my weight did in c/glp1women · 0 points · 14 days ago

Strongly agree. Cycle changes are documented.

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comment on [Explainer] the four things a COA must have or it is decorative in c/coa · 20 points · 15 days ago

the batch number or it did not happen

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comment on [Discussion] denial reason codes decoded, mostly fixable paperwork in c/insurancefights · 6 points · 16 days ago

External review overturned the denial. Took 23 weeks but the process exists.

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comment on bloodwork — my 22-week log, condensed into one table in c/bloodwork · 24 points · 25 days ago

I am going to push back on this slightly.

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comment on unpopular opinion: dose history is massively overrated in c/dosinglogs · 5 points · 27 days ago

Week 7 for me and the honest summary is: 35kg down, sulphur burps manageable, and I have thought about food maybe four times today.

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comment on week 26 check-in — 31kg down, muscle cramps manageable, one thing confusing me in c/bloodwork · 15 points · 28 days ago

eGFR noise during rapid loss is expected

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comment on identity and quantity are two questions and most COAs answer one in c/coa · 53 points · 1 months ago

Strongly agree. Mass% and area% are answering different questions on the same document.

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comment on the weight thing finally clicked for me and I want to write it down in c/dosinglogs · 4 points · 1 months ago

The evidence standard in c/vendorvetting gets called too strict about once a month, and every time, the thread ends with the complainant agreeing.

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comment on [Discussion] the copay advice in here is 4 years out of date in c/insurancefights · 20 points · 1 months ago

Retitled to remove editorialising. Put the evidence in the body.

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