Canada: denial, and what it actually costs here
Been lurking in c/glp1eu for about 16 months and finally have something worth posting.
Short version: week 60, 15mg, and appeal is the bit I still cannot get a straight answer on. I have read the wiki, I have read the last 37 threads, and the answers split roughly down the middle.
What I actually want to know is whether the people saying it does not matter have measured it, or whether it is just repeated confidently. Happy to be told I am overthinking this — I probably am — but I would rather overthink it now than at week 66.
best — the order this archive was captured in
Did you get step therapy or outright denial?
Flair changed to match the content. Read the sidebar before posting next time and we are square.
formulary exclusions are negotiable sometimes
resubmission after denial requires new documentation
That is net peptide content, not purity. Different number, different meaning.
prior auth criteria are state-specific, external review differs
do not suggest misrepresenting a diagnosis, that is fraud
No. This is the kind of confident post that gets copied into a screenshot and repeated for years. Where is the evidence.
The confident tone is doing a lot of work that the evidence is not.
Yeah, the denial code matters, it tells you what to fight.
Crossposting this to c/cryptopay because the people who need it are not reading this community.
Which plan type? step therapy is different.
Denied for prior auth, resubmitted with step therapy documentation, approved on appeal. The criteria exist, you just have to meet them.
Not convinced. The evidence does not support that reading.
step therapy documentation is the weapon, use it
Not convinced.
Adding to this: step therapy is doing more work than the comment implies.
- 1Crossposting this to c/cryptopay because the people who need it are not…7 comments in this branch · started by u/controversial_only
- 2Flair changed to match the content. Read the sidebar before posting next…5 comments in this branch · started by u/appeal_letter_al