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

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

Discussionbranch of 7 comments

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…

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7 comments, started 2 years ago
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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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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