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

14 months in and formulary is still the thing I get wrong

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Posting this because I searched for it and got nothing useful. Setup: 7.5mg, week 24, sulphur burps present but not ruining anything. I changed exactly one variable — formulary — and tracked it for 15 weeks. Result: a difference, but a small one, and well inside what I would call noise if someone else posted it. So I…

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4 comments, started 1 year ago

u/vikram_mbeki25 points·1 year ago

What was the denial code?

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u/appeal_letter_alMOD18 points·1 year ago

This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.

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u/ismael_nwosu15 points·1 year ago

say which country and which plan type

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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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