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c/insurancefights·submitted 1 year ago by u/rekha_mbeki

formulary vs step therapy — genuinely asking which matters more

Questionbranch of 14 comments

step therapy. That is the whole post, but I will justify it. Everything else people worry about in c/dosinglogs is downstream of it. Titration speed, reflux, the endless dose arguments — most of it resolves if you sort step therapy out first, and almost nobody does. I say this having got it wrong for 15 months. My…

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14 comments, started 1 year ago
u/ignacio_vanhecke82 points·1 year ago

The confident tone is doing a lot of work that the evidence is not.

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u/fabio_kuipers66 points·1 year ago

step therapy documentation is the weapon, use it

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u/rekha_mbekiOP52 points·1 year ago

step therapy documentation is the weapon, use it

Disagree on that part. 93.7% and 99.3% on the same vial is normal.

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u/honest_syringe1918 points·1 year ago

Which plan type? denial is different.

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u/dose_diary_danalog keeper0 points·1 year ago

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

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u/line_bergstrom1 point·1 year ago

formulary exclusions are negotiable sometimes

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u/amira_dumitru1 point·1 year ago

formulary exclusions are negotiable sometimes

Adding to this: formulary is doing more work than the comment implies.

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u/peak_area_peteanalytical33 points·1 year ago

prior auth criteria are state-specific, step therapy differs

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u/ireland_drugs_pay18 points·1 year ago

prior auth criteria are state-specific, step therapy differs

Yes, exactly this, and it is the bit that took me 6 weeks to accept.

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u/rekha_mbekiOP14 points·1 year ago·edited

denial reason codes matter, ask for the actual code

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u/rekha_mbekiOP8 points·1 year ago

copay is separate from coverage

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u/amylin_amyamylin56 points·1 year ago

Which plan type? appeal is different.

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u/nikhil_asante31 points·1 year ago

Strongly agree. Step therapy is predictable if you have the criteria.

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About c/insurancefights

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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