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

appeal — 4 things I got wrong before I got it right

Appeal Long Haul ×1 Slow Clap ×3

appeal — 4 things I got wrong before I got it right — a position I have arrived at slowly and would like tested.

Missed a deadline because I counted from when I opened the envelope. That mistake cost me an entire cycle.

External review was the thing that finally worked. I did not know it existed until a thread on this board.

New plan year, entirely new criteria, and the denial that had been immovable in the autumn simply did not apply in January.

Ask me anything specific. Anything general I will probably get wrong.

2,816 up / 346 down89% upvoted28 commentsid f122b526 Jul 2024

28 comments

20 in this archive, depth 4

best — the order this archive was captured in

u/maren_ibarra273 points·2 years ago

Internal appeals are decided by the plan. External review is decided by an independent body and, where it applies, its determination is binding. They are separate mechanisms and the second is chronically underused.

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u/arne_amankwah169 points·2 years ago·edited

Have you asked for the clinical policy bulletin by number?

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u/teodor_duarteOP97 points·2 years ago·edited

Which country and which plan year are we talking about?

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u/teodor_duarteOP200 points·2 years ago

Employer plan or individual plan?

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u/hassan_chowdhury159 points·2 years ago

the second-level appeal is where things actually turn

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u/ahmed_abubakar124 points·2 years ago

the diagnosis code on the claim is doing more work than anything you write

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u/purity_pedantanalytical78 points·2 years ago·edited

This. Step therapy is a paperwork requirement and it is beaten with documentation, not persuasion.

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u/camila_vasquez102 points·2 years ago

Yes — quoting their own policy bulletin back at them is far more effective than arguing in general terms.

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u/maren_ibarra27 points·2 years ago

Employer-sponsored plans may be regulated differently from individually purchased ones, which changes both the appeal route and which regulator hears a complaint.

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u/ahmed_abubakar53 points·2 years ago

Yes — quoting their own policy bulletin back at them is far more effective than arguing in general terms.

This is the whole method. Answer the criterion they named, not the decision in general.

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u/line_bergstrom18 points·2 years ago

This is the whole method.

ahmed_abubakar is right that this is documentation rather than persuasion. It took me a year to accept that.

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u/maren_sorensen14 points·2 years ago

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.

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[deleted]13 points·2 years ago

[deleted]

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u/elise_grimaldi77 points·2 years ago

Prior authorisation criteria are republished each plan year. A criterion that blocked you in one year may not exist in the next, so a denial is worth retesting after the turnover.

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u/elin_varga95 points·2 years ago

Prior authorisation criteria are republished each plan year.

Adding the underused one — external review. Independent, binding where it applies, and hardly anybody gets that far.

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u/teodor_duarteOP46 points·2 years ago

What has been documented as tried, and for how long?

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u/hassan_castellanos43 points·2 years ago

What exactly does the denial letter give as the reason?

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u/muscle_cramp_mo56 points·2 years ago

Disagree with the tone strategy. Anger has never moved a determination; matching the criterion has.

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u/marta_marchand27 points·2 years ago

A denial letter is required to state a reason and to reference the criterion applied. That reference is the handle: request the clinical policy document by its identifier and answer it point by point.

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u/pavel_nkemelu16 points·2 years ago

ask for the denial reason in writing, always

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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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