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Single comment threadYou are looking at one branch of stalled for 6 weeks at 2.4mg and I refuse to panic this time — 64 comments in the full submission. View in context.
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c/insurancefights·submitted 2 years ago by u/kaia_cabrera

stalled for 6 weeks at 2.4mg and I refuse to panic this time

Appealbranch of 8 comments

Quick one. Canada here. denial works very differently where I live than in the threads that dominate the front page, and I keep seeing people confidently given advice that simply does not apply outside the US. Specifics: the route I used took 2 weeks and cost roughly what I expected. The admin was worse than the…

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This branch

8 comments, started 2 years ago
u/saskia_rahimi167 points·2 years ago

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

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u/whois_wanda38 points·2 years ago

external review is the appeal after insurance says no

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[deleted]27 points·2 years ago

[deleted]

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u/kaia_cabreraOP15 points·2 years ago

Poland plan: step therapy required 23 medications first. Did them all, got approval. The order matters.

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u/kaia_cabreraOP27 points·2 years ago

copay is separate from coverage

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u/kaia_cabreraOP20 points·2 years ago

redact member ids and group numbers from every screenshot

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u/ines_krastev12 points·2 years ago

copay is separate from coverage

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u/emeka_delgado3 points·2 years ago

appeal letter templates are in the wiki

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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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