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Single comment threadYou are looking at one branch of copay is the most under-discussed thing in c/labresults — 52 comments in the full submission. View in context.
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copay is the most under-discussed thing in c/labresults

Winbranch of 10 comments

Week 8 update. 4kg down from the start, muscle cramps basically gone since about week 48. Things that worked: consistency, protein at breakfast, walking more than I want to. Things that did not: everything I bought on the internet to help with muscle cramps. The part that surprised me is how much of this is admin.…

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10 comments, started 1 year ago
u/gustav_vermeulen159 points·1 year ago

redact member ids and group numbers from every screenshot

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u/plain_titration_202441 points·1 year ago

Disagree but this is the good kind of wrong — it is specific enough to be checked.

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u/elin_lindqvist38 points·1 year ago

formulary exclusions are negotiable sometimes

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u/bence_zielinski30 points·1 year ago·edited

Strongly agree. Step therapy is predictable if you have the criteria.

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u/honest_syringe190 points·1 year ago

external review is the appeal after insurance says no

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u/ignacio_vanhecke70 points·1 year ago

do not suggest misrepresenting a diagnosis, that is fraud

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u/plain_titration_202429 points·1 year ago

do not suggest misrepresenting a diagnosis, that is fraud

Yes, exactly this, and it is the bit that took me 54 weeks to accept.

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u/kasper_cabrera42 points·1 year ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/oskar_kaufmann56 points·1 year ago·edited

external review is the appeal after insurance says no

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u/amylin_amyamylin35 points·1 year ago

external review is the appeal after insurance says no

Yes, exactly this, and it is the bit that took me 53 weeks to accept.

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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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