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c/insurancefights·submitted 1 months ago by u/sock_puppet_spotter

[Discussion] the copay advice in here is 4 years out of date

Discussionbranch of 6 comments

external review. That is the whole post, but I will justify it. Everything else people worry about in c/dosinglogs is downstream of it. Titration speed, muscle cramps, the endless dose arguments — most of it resolves if you sort external review out first, and almost nobody does. I say this having got it wrong for 21…

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6 comments, started 1 months ago
u/niels_salinas8 points·1 months ago

This is correct. Appeal letters work.

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u/greta_chukwu6 points·1 months ago

What was the denial code?

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u/milan_wikstrom2 points·1 months ago

resubmission after denial requires new documentation

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u/nikhil_asante2 points·1 months ago

This is correct.

Disagree on that part. 98.6% and 98.7% on the same vial is normal.

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u/amira_dumitru2 points·1 months ago

say which country and which plan type

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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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