[Meta] proposal — a flair for formulary posts
I have had 2 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 20 days on nominally the same lane, which matters more in summer than in February.
The independent number came back 96.8% against a claimed 97.2%, 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
step therapy documentation is the weapon, use it
I am going to push back on this slightly.
step therapy documentation is the weapon, use it
do not suggest misrepresenting a diagnosis, that is fraud
Yeah, the denial code matters, it tells you what to fight.
the carve-out clause varies by employer
resubmission after denial requires new documentation
Yeah, the denial code matters, it tells you what to fight.
denial reason codes matter, ask for the actual code
Tracking number removed. It identifies both ends of a shipment.
prior auth criteria are state-specific, external review differs
This is correct. Appeal letters work.
What was the denial code?
Yeah, the denial code matters, it tells you what to fight.
formulary exclusions are negotiable sometimes
Yeah, the denial code matters, it tells you what to fight.
External review overturned the denial. Took 3 weeks but the process exists.
- 1step therapy documentation is the weapon, use it10 comments in this branch · started by u/honest_syringe19
- 2Tracking number removed. It identifies both ends of a shipment.7 comments in this branch · started by u/prior_auth_pain