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c/insurancefights·posted 10 months ago by u/jarno_adeyemi

how much of what we believe about step therapy actually comes from prior authorization threads

Template Long Haul ×6 Cold Box ×1 Well Actually ×2

Question in the title, detail here: how much of what we believe about step therapy actually comes from prior authorization threads.

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.

Kept a log with every date, name of department and reference number. When they claimed no record of a call, I had the reference.

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

If somebody has the same thing measured a different way, post it next to mine and we will see whether they agree.

4,971 up / 1,821 down73% upvoted9 commentsid 1e8khp15 Sep 2025

9 comments

5 in this archive, depth 2

best — the order this archive was captured in

u/edit_for_clarity232 points·10 months ago

Why step therapy denials feel unfair and are nonetheless beatable.

The requirement is that documented trials of preferred alternatives exist. It is a record-keeping standard, not a clinical judgement about you, which is why arguing the clinical merits rarely moves it and producing dates and durations often does.

What to assemble: what was tried, at what dose, for how long, and what the documented outcome was. A one-page table with dates beats three pages of prose every time. Where a trial is contraindicated rather than simply unsuccessful, that needs to be stated explicitly by the prescriber in those terms.

None of this is legal or medical advice — it is what the threads here have found works.

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u/gustav_vermeulen136 points·10 months ago

Peer-to-peer took fifteen minutes and resolved something a written appeal had been sitting on for a month.

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u/liv_kuipers84 points·10 months ago

Yes — quoting their own policy bulletin back at them is far more effective than arguing in general terms.

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u/jarno_adeyemiOP99 points·10 months ago

Peer-to-peer took fifteen minutes and resolved something a written appeal had been sitting on for a month.

Agreed — and request the bulletin by number. They have to give it to you.

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u/cardio_endpoint_c113 points·10 months ago

Peer-to-peer took fifteen minutes and resolved something a written appeal had been sitting on for a month.

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

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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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