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step therapy is the most under-discussed thing in c/labresults
Quick one. Canada here. prior authorization works very differently where I live than in the threads that dominate the front page, and I keep seeing people confidently given advice that simply does not apply outside the US. Specifics: the route I used took 15 weeks and cost roughly what I expected. The admin was worse…
Mechanistically the bit that matters is external review. It explains most of the early profile and a decent chunk of the outcome.
Yeah, the denial code matters, it tells you what to fight.
[removed]7 points·1 year ago
[removed by moderator]
Not to be pedantic but formulary and appeal are being used interchangeably and they are not interchangeable in real life.