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

switched from 10mg to 0.25mg and the constipation got better, not worse

Discussion Slow Clap ×4 Receipts ×3 Clean Column ×2

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.

8,065 up / 3,030 down73% upvoted55 commentsid fb1o0429 Apr 2024

55 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/marta_vanhecke411 points·2 years ago

Poland plan: step therapy required 10 medications first. Did them all, got approval. The order matters.

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u/nnt_nateOP593 points·2 years ago

Rodent data is rodent data. Dose scaling is not linear and the models tell you what to investigate, not what to expect.

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u/hedda_aguirre291 points·2 years ago

formulary exclusions are negotiable sometimes

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u/greta_chukwu93 points·2 years ago

formulary exclusions are negotiable sometimes

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/formulary_fighterMOD223 points·2 years ago

This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.

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u/runa_wikstrom193 points·2 years ago

appeal letter templates are in the wiki

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u/vikram_mbeki43 points·2 years ago

prior auth criteria are state-specific, external review differs

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u/marisol_moreau273 points·2 years ago

Dead space in the needle hub holds a small but non-trivial volume. On low-volume draws that can be several units.

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u/adaeze_weiss179 points·2 years ago

copay is separate from coverage

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u/line_petrov78 points·2 years ago

Small correction: the trial was 22 weeks, not 34. Does not change your point but people will quote it.

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u/vikram_mbeki65 points·2 years ago

resubmission after denial requires new documentation

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u/nadia_trevino49 points·2 years ago

copay is separate from coverage

Disagree on that part. 99.0% and 98.9% on the same vial is normal.

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u/kian_balogun58 points·2 years ago

Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.

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u/purity_pedantanalytical99 points·2 years ago

Copay was step therapy for the copay then another 21% of the total. Read the actual plan document.

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[deleted]44 points·2 years ago

[deleted]

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u/wholesome_lurker86 points·2 years ago

I love that this community will spend 40 comments on a detail. That pedantry is why the numbers here matter.

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u/rekha_mbeki-35 points·2 years ago

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.

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u/honest_syringe1964 points·2 years ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/osman_ferrari18 points·2 years ago

I am going to push back on this slightly.

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u/teodor_duarte10 points·2 years ago

the carve-out clause varies by employer

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u/ignacio_vanhecke20 points·2 years ago

appeal letter templates are in the wiki

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u/sock_puppet_spotter51 points·2 years ago

Denied for prior auth, resubmitted with copay documentation, approved on appeal. The criteria exist, you just have to meet them.

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u/ferran_batista38 points·2 years ago

Yeah, the denial code matters, it tells you what to fight.

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u/marta_marchand33 points·2 years ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/nnt_nateOP25 points·2 years ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/canada_coverage28 points·2 years ago

prior auth criteria are state-specific, external review differs

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u/bence_zielinski6 points·2 years ago

appeal letter templates are in the wiki

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u/canada_coverage7 points·2 years ago

appeal letter templates are in the wiki

Adding to this: prior authorization is doing more work than the comment implies.

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u/milos_vestergaard4 points·2 years ago

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.

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u/line_bergstrom3 points·2 years ago

redact member ids and group numbers from every screenshot

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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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