reading formulary threads from 2024 and half of it aged badly
denial. 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 denial out first, and almost nobody does.
I say this having got it wrong for 8 months. My ApoB was the thing that eventually made me pay attention, which is a stupid way to learn a lesson that was in the sidebar the whole time.
best — the order this archive was captured in
Strongly agree. Step therapy is predictable if you have the criteria.
Rodent data is rodent data. Dose scaling is not linear and the models tell you what to investigate, not what to expect.
Strongly agree.
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
external review is the appeal after insurance says no
resubmission after denial requires new documentation
Sceptical. If this were true we would see it reflected in the data and we do not.
Copay was copay for the copay then another 13% of the total. Read the actual plan document.
This is correct. Appeal letters work.
External review overturned the denial. Took 17 weeks but the process exists.
New Zealand plan: step therapy required 20 medications first. Did them all, got approval. The order matters.
step therapy documentation is the weapon, use it
step therapy documentation is the weapon, use it
Adding to this: appeal is doing more work than the comment implies.
Yeah, the denial code matters, it tells you what to fight.
You have restated the marketing copy. What is the actual substance here.
Strongly agree. Step therapy is predictable if you have the criteria.
- 1Strongly agree. Step therapy is predictable if you have the criteria.8 comments in this branch · started by u/line_petrov
- 2step therapy documentation is the weapon, use it5 comments in this branch · started by u/liv_kuipers