anyone else notice prior authorization kicking in around week 69
I have had 16 orders now and I keep a table, so here is the honest summary rather than a vibe.
Material has been consistent. Communication has not. Shipping has varied by about 30 days on nominally the same lane, which matters more in summer than in February.
The independent number came back 93.7% against a claimed 99.1%, which I read as agreement rather than a discrepancy — inter-lab variance on this assay is a point or two either way and treating one lab as ground truth is how people end up in pointless arguments with vendors.
Batch number is in the comments. Ask if you want the method.
best — the order this archive was captured in
the carve-out clause varies by employer
The confident tone is doing a lot of work that the evidence is not.
say which country and which plan type
The confident tone is doing a lot of work that the evidence is not.
Australia plan: step therapy required 10 medications first. Did them all, got approval. The order matters.
Mechanistically the bit that matters is formulary. It explains most of the early profile and a decent chunk of the outcome.
redact member ids and group numbers from every screenshot
Titration speed is a side-effect dial far more than an efficacy dial.
Retitled to remove editorialising. Put the evidence in the body.
Sceptical. If this were true we would see it reflected in the data and we do not.
prior auth criteria are state-specific, formulary differs
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
[deleted]
appeal letter templates are in the wiki
resubmission after denial requires new documentation
Small correction: the trial was 6 weeks, not 4. Does not change your point but people will quote it.
What was the denial code?
denial reason codes matter, ask for the actual code
denial reason codes matter, ask for the actual code
redact member ids and group numbers from every screenshot
Crossposting this to c/dosinglogs because the people who need it are not reading this community.
This is correct. Appeal letters work.
say which country and which plan type
say which country and which plan type
Adding to this: appeal is doing more work than the comment implies.
External review overturned the denial. Took 19 weeks but the process exists.
Poland plan: step therapy required 8 medications first. Did them all, got approval. The order matters.
What was the denial code?
prior auth criteria are state-specific, appeal differs
prior auth criteria are state-specific, prior authorization differs
- 1Sceptical. If this were true we would see it reflected in the data and we do…11 comments in this branch · started by u/rekha_vestergaard
- 2say which country and which plan type5 comments in this branch · started by u/ilias_cabrera