switched from 10mg to 0.25mg and the constipation got better, not worse
prior authorization. That is the whole post, but I will justify it.
Everything else people worry about in c/dosinglogs is downstream of it. Titration speed, early fullness, the endless dose arguments — most of it resolves if you sort prior authorization out first, and almost nobody does.
I say this having got it wrong for 17 months. My eGFR 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
Poland plan: step therapy required 10 medications first. Did them all, got approval. The order matters.
Rodent data is rodent data. Dose scaling is not linear and the models tell you what to investigate, not what to expect.
formulary exclusions are negotiable sometimes
formulary exclusions are negotiable sometimes
Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.
This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.
appeal letter templates are in the wiki
prior auth criteria are state-specific, external review differs
Dead space in the needle hub holds a small but non-trivial volume. On low-volume draws that can be several units.
copay is separate from coverage
Small correction: the trial was 22 weeks, not 34. Does not change your point but people will quote it.
resubmission after denial requires new documentation
copay is separate from coverage
Disagree on that part. 99.0% and 98.9% on the same vial is normal.
Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.
Copay was step therapy for the copay then another 21% of the total. Read the actual plan document.
I love that this community will spend 40 comments on a detail. That pedantry is why the numbers here matter.
I love that this community will spend 40 comments on a detail.
Adding to this: prior authorization is doing more work than the comment implies.
Strongly agree. Step therapy is predictable if you have the criteria.
I am going to push back on this slightly.
the carve-out clause varies by employer
appeal letter templates are in the wiki
Denied for prior auth, resubmitted with copay documentation, approved on appeal. The criteria exist, you just have to meet them.
Yeah, the denial code matters, it tells you what to fight.
Strongly agree. Step therapy is predictable if you have the criteria.
Strongly agree. Step therapy is predictable if you have the criteria.
prior auth criteria are state-specific, external review differs
appeal letter templates are in the wiki
appeal letter templates are in the wiki
Adding to this: prior authorization is doing more work than the comment implies.
appeal letter templates are in the wiki Adding to this: prior authorization is doing more work than the comment implies.
Adding to this: step therapy is doing more work than the comment implies.
redact member ids and group numbers from every screenshot
- 1Poland plan: step therapy required 10 medications first. Did them all, got…7 comments in this branch · started by u/marta_vanhecke
- 2I love that this community will spend 40 comments on a detail. That pedantry…6 comments in this branch · started by u/wholesome_lurker