step therapy is the most under-discussed thing on this board
step therapy is the most under-discussed thing on this board. It is the sort of thing everyone half-believes and nobody writes down. External review was the thing that finally worked. I did not know it existed until a thread on this board. Documented eighteen months of what had been tried in a one-page table. That…
a template letter that quotes their own criteria back is the strongest one
keep every date, every reference number, every name of a department
Appeal deadlines run from the date on the determination letter. They are strict, they are short, and a missed deadline usually forfeits that level entirely.
deadlines run from the letter date, not from when you opened it
This. Step therapy is a paperwork requirement and it is beaten with documentation, not persuasion.
prior authorisation criteria change every plan year