nobody warned me about the food-noise thing and I would have liked the warning
Something I noticed reading old threads that I have not seen said out loud. The advice on external review 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…
The confident tone is doing a lot of work that the evidence is not.
appeal letter templates are in the wiki
Not convinced. The evidence does not support that reading.
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formulary exclusions are negotiable sometimes
resubmission after denial requires new documentation
I am going to push back on this slightly.
Not to be pedantic but external review and prior authorization are being used interchangeably and they are not interchangeable in real life.
do not suggest misrepresenting a diagnosis, that is fraud