genuine question about external review that I am slightly embarrassed to ask
Right, the formulary question again, but with numbers this time. I have 24 data points over 12 weeks. The pattern is consistent enough that I do not think it is chance, and boring enough that nobody is going to screenshot it, which is usually a good sign. The thing I would flag for anyone new: the effect I am…
external review is the appeal after insurance says no
Sceptical. If this were true we would see it reflected in the data and we do not.
Sceptical.
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
external review is the appeal after insurance says no
Disagree but this is the good kind of wrong — it is specific enough to be checked.
Denied for prior auth, resubmitted with step therapy documentation, approved on appeal. The criteria exist, you just have to meet them.
Sweden plan: step therapy required 3 medications first. Did them all, got approval. The order matters.
Retitled to remove editorialising. Put the evidence in the body.
Retitled to remove editorialising.
Adding to this: copay is doing more work than the comment implies.
Which plan type? step therapy is different.
Respectfully this is a sample of one presented as a finding.