[Results] 17 weeks, 36kg, and denial was the hard part
Long-ish post, sorry. tl;dr at the bottom.
I have been tracking appeal against ApoB for 17 weeks because I could not find anyone who had. The correlation is weaker than I expected, which is itself mildly interesting given how confidently people link the two in here.
Caveats up front: one person, one lab, one assay, no control, and I changed my training in the middle of it, which was stupid.
tl;dr: probably real, definitely smaller than the threads imply, and not worth reorganising your week around.
best — the order this archive was captured in
Denied for prior auth, resubmitted with prior authorization documentation, approved on appeal. The criteria exist, you just have to meet them.
formulary exclusions are negotiable sometimes
Which state? Coverage varies.
Strongly agree. Step therapy is predictable if you have the criteria.
Respectfully this is a sample of one presented as a finding.
Tracking number removed. It identifies both ends of a shipment.
Did you get step therapy or outright denial?
prior auth criteria are state-specific, step therapy differs
resubmission after denial requires new documentation
Did you get step therapy or outright denial?
step therapy documentation is the weapon, use it
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
external review is the appeal after insurance says no
do not suggest misrepresenting a diagnosis, that is fraud
do not suggest misrepresenting a diagnosis, that is fraud
Yes, exactly this, and it is the bit that took me 94 weeks to accept.
Which plan type? prior authorization is different.
external review is the appeal after insurance says no
- 1resubmission after denial requires new documentation7 comments in this branch · started by u/idris_iyer