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Single comment threadYou are looking at one branch of [Meta] proposal — a flair for formulary posts — 26 comments in the full submission. View in context.
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c/insurancefights·submitted 1 year ago by u/gustav_vermeulen

[Meta] proposal — a flair for formulary posts

Discussionbranch of 7 comments

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…

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7 comments, started 1 year ago
u/prior_auth_painMOD56 points·1 year ago

Tracking number removed. It identifies both ends of a shipment.

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u/adaeze_cabrera13 points·1 year ago

prior auth criteria are state-specific, external review differs

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u/coring_the_stopper42 points·1 year ago

This is correct. Appeal letters work.

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u/nikhil_asante26 points·1 year ago

What was the denial code?

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u/bence_zielinski19 points·1 year ago

Yeah, the denial code matters, it tells you what to fight.

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u/oskar_kaufmann12 points·1 year ago·edited

formulary exclusions are negotiable sometimes

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u/ismael_nwosu33 points·1 year ago

Yeah, the denial code matters, it tells you what to fight.

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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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