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31
c/insurancefights·posted 4 days ago by u/vikram_mbeki

[Denied] reason code says "not medically necessary" at BMI 38. sure.

Denied

reason code says "not medically necessary" at BMI 38. sure. Making the case below, and I expect to lose some of it in the comments.

Documented eighteen months of what had been tried in a one-page table. That table was the appeal.

External review was the thing that finally worked. I did not know it existed until a thread on this board.

New plan year, entirely new criteria, and the denial that had been immovable in the autumn simply did not apply in January.

Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.

46 up / 15 down75% upvoted14 commentsid 1b4jq025 Jul 2026

14 comments

14 in this archive, depth 4

best — the order this archive was captured in

u/gustav_vermeulen8 points·4 days ago

Prior authorisation criteria are republished each plan year. A criterion that blocked you in one year may not exist in the next, so a denial is worth retesting after the turnover.

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u/tuva_kirchner5 points·4 days ago

Same view. The second-level appeal is where mine turned, after a first-level denial that looked final.

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u/ignacio_vanhecke3 points·3 days ago

the formulary is published, read it before you appeal

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u/edit_for_clarity7 points·3 days ago

Step therapy requires documented trial of preferred alternatives. It is not an argument to be won on merits; it is a record to be produced, and the record is what the appeal must contain.

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u/prior_auth_painMOD6 points·2 days ago

Left up. It carries dates, a criterion and an outcome, which is what makes these threads useful.

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u/hedda_aguirre9 points·2 days ago

A denial letter is required to state a reason and to reference the criterion applied. That reference is the handle: request the clinical policy document by its identifier and answer it point by point.

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[removed]6 points·2 days ago

[removed by moderator]

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u/honest_syringe190 points·2 days ago

A denial letter is required to state a reason and to reference the criterion applied.

Adding the underused one — external review. Independent, binding where it applies, and hardly anybody gets that far.

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u/vikram_mbekiOP1 point·2 days ago

Correcting myself upthread: the deadline was 23 days, not the figure I gave.

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u/ferran_dahlberg5 points·2 days ago

Push back: your plan is an employer plan, which changes both the appeal path and who the regulator is.

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u/adaeze_weiss2 points·2 days ago

Spent six weeks arguing in general terms and got nowhere. Two paragraphs quoting their own criteria turned it around in eleven days.

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u/oskar_kaufmann4 points·3 days ago

I would not skip the peer-to-peer. It is often the fastest route and it costs a phone call.

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u/solene_eriksen1 point·3 days ago

I would not skip the peer-to-peer.

oskar_kaufmann is right that this is documentation rather than persuasion. It took me a year to accept that.

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u/vikram_mbekiOP1 point·3 days ago

Correction: that is a formulary exclusion, not a prior authorisation denial. Different form, different route, different deadline.

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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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