[Meta] proposal — a flair for prior authorization posts
Something I noticed reading old threads that I have not seen said out loud.
The advice on copay in this community changed substantially around the start of last year, and nobody went back and updated the older posts. So depending on which thread the search engine hands you, you get two contradictory answers with the same confidence.
I have listed what I think the current consensus is below. Correct me — that is the point of posting it.
best — the order this archive was captured in
Tracking number removed. It identifies both ends of a shipment.
say which country and which plan type
External review overturned the denial. Took 22 weeks but the process exists.
formulary exclusions are negotiable sometimes
Denied for prior auth, resubmitted with denial documentation, approved on appeal. The criteria exist, you just have to meet them.
Half-life is about 168 hours, so steady state lands around week 13–5. Practical consequence: what you feel in week 1 is not what that dose does.
Respectfully this is a sample of one presented as a finding.
You have restated the marketing copy. What is the actual substance here.
do not suggest misrepresenting a diagnosis, that is fraud
What was the denial code?
resubmission after denial requires new documentation
What was the denial code?
Yes, exactly this, and it is the bit that took me 10 weeks to accept.
redact member ids and group numbers from every screenshot
- 1Tracking number removed. It identifies both ends of a shipment.5 comments in this branch · started by u/step_therapy_s
- 2What was the denial code?4 comments in this branch · started by u/niels_salinas