[Discussion] can we stop arguing about external review until somebody posts a number
I have had 13 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 10 days on nominally the same lane, which matters more in summer than in February.
The independent number came back 93.7% against a claimed 98.6%, 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
resubmission after denial requires new documentation
Did you get step therapy or outright denial?
Denied for prior auth, resubmitted with formulary documentation, approved on appeal. The criteria exist, you just have to meet them.
formulary exclusions are negotiable sometimes
Not to be pedantic but formulary and appeal are being used interchangeably and they are not interchangeable in real life.
Small correction: the trial was 20 weeks, not 11. Does not change your point but people will quote it.
Every time this gets posted it hits the front page and every time someone has to re-explain it.
the carve-out clause varies by employer
the carve-out clause varies by employer
Adding to this: appeal is doing more work than the comment implies.
Respectfully this is a sample of one presented as a finding.
Three years on this site and the questions have not changed at all. Which is depressing or reassuring depending on the day.
Three years on this site and the questions have not changed at all.
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
Tracking number removed. It identifies both ends of a shipment.
- 1Did you get step therapy or outright denial?5 comments in this branch · started by u/formulary_fighter