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[Question] copay — what am I missing here
copay — what am I missing here. If this has been answered properly somewhere, link me and I will delete. A peer-to-peer conversation puts the prescribing clinician in front of a reviewing clinician. It bypasses the correspondence cycle entirely and is often the fastest available route. Appeal deadlines run from the…
ask for the denial reason in writing, always
prior authorisation criteria change every plan year
Not convinced. That is a formulary exclusion rather than a prior authorisation denial, and the route to challenge it is different.
[removed]16 points·1 year ago
[removed by moderator]
the denial letter names the criterion, start there
deadlines run from the letter date, not from when you opened it