[Meta] proposal — a flair for special authorization posts
proposal — a flair for special authorization posts. Nothing about this affects the ranking maths, before anyone asks. Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing. A rejected claim at the pharmacy…
Spent three weeks on what turned out to be a quantity limit rather than a coverage question.
Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary. Which one applies determines everything about the route.
a denial letter names a criterion, that is your handle
Correction: that is regulatory approval, not coverage. They are separate decisions by separate bodies.
Correcting myself: it was a quantity limit rather than a denial, which changes the whole process.
say the province or the answers will be wrong
quantity limits are as common a barrier as coverage itself