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c/insurancefights·posted 2 years ago by u/janoshik_junkie

small win: step therapy stopped being a problem at week 35

Discussion Receipts ×5 Long Haul ×3

Posting this because I searched for it and got nothing useful.

Setup: 15mg, week 75, injection-site soreness present but not ruining anything. I changed exactly one variable — copay — and tracked it for 17 weeks.

Result: a difference, but a small one, and well inside what I would call noise if someone else posted it. So I am putting it here rather than presenting it as a finding. If two or three other people have done the same thing we might actually learn something.

Not medical advice, obviously. This is one person with a spreadsheet.

1,894 up / 373 down84% upvoted69 commentsid cj5n2e23 Mar 2024

69 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/ahmed_abubakar174 points·2 years ago·edited

I am going to push back on this slightly.

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u/curious_panel_only109 points·2 years ago

appeal letter templates are in the wiki

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u/maren_ibarra159 points·2 years ago

Inter-lab variance on this kind of assay is routinely 1–2 points. Different column, different gradient, different integration.

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u/tomas_lehtinen133 points·2 years ago

Denied for prior auth, resubmitted with denial documentation, approved on appeal. The criteria exist, you just have to meet them.

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u/formulary_fighterMOD84 points·2 years ago·edited

Flair changed to match the content. Read the sidebar before posting next time and we are square.

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u/tuva_aalto19 points·2 years ago

Flair changed to match the content.

Yes, exactly this, and it is the bit that took me 5 weeks to accept.

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[deleted]8 points·2 years ago

[deleted]

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u/neha_erdogan3 points·2 years ago

copay is separate from coverage

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u/oskar_kaufmann94 points·2 years ago

denial reason codes matter, ask for the actual code

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u/bence_zielinski77 points·2 years ago

What was the denial code?

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u/elise_grimaldi37 points·2 years ago

prior auth criteria are state-specific, copay differs

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u/plain_titration_202473 points·2 years ago
well that is my evening gone, thanks for the paper
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u/hplc_hobbyistruns their own column25 points·2 years ago·edited

This is correct. Appeal letters work.

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u/tuva_aalto36 points·2 years ago

well that is my evening gone, thanks for the paper

Yes, exactly this, and it is the bit that took me 54 weeks to accept.

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u/curious_panel_only28 points·2 years ago·edited

prior auth criteria are state-specific, prior authorization differs

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u/kaia_cabrera0 points·2 years ago

prior auth criteria are state-specific, prior authorization differs

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/vikram_mbeki35 points·2 years ago

formulary exclusions are negotiable sometimes

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u/marisol_moreau49 points·2 years ago

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

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u/janoshik_junkieOPindependent tester20 points·2 years ago

prior auth criteria are state-specific, denial differs

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u/marta_marchand32 points·2 years ago

Which state? Coverage varies.

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u/pavel_nkemelu11 points·2 years ago

redact member ids and group numbers from every screenshot

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u/marta_vanhecke35 points·2 years ago

step therapy documentation is the weapon, use it

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u/vikram_mbeki19 points·2 years ago

Did you get step therapy or outright denial?

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u/gustav_vermeulen6 points·2 years ago·edited

Did you get step therapy or outright denial?

Disagree on that part. 97.9% and 97.6% on the same vial is normal.

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u/ferran_batista23 points·2 years ago·edited

Sceptical. If this were true we would see it reflected in the data and we do not.

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u/hamza_weiss19 points·2 years ago

prior auth criteria are state-specific, copay differs

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u/blunt_coldbox_notes13 points·2 years ago·edited

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

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u/janoshik_junkieOPindependent tester18 points·2 years ago

External review overturned the denial. Took 13 weeks but the process exists.

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u/rekha_mbeki4 points·2 years ago

formulary exclusions are negotiable sometimes

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u/kasper_cabrera24 points·2 years ago

step therapy documentation is the weapon, use it

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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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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