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c/insurancefights·posted 1 year ago by u/osman_ferrari

the step therapy thing finally clicked for me and I want to write it down

Appeal Cold Box ×1

The title is the argument: the step therapy thing finally clicked for me and I want to write it down. Here is the rest of it.

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

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

Missed a deadline because I counted from when I opened the envelope. That mistake cost me an entire cycle.

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

275 up / 9 down97% upvoted22 commentsid a9zetf20 Dec 2024

22 comments

19 in this archive, depth 5

best — the order this archive was captured in

u/marta_dziedzic45 points·1 year ago

A peer-to-peer conversation puts the prescribing clinician in front of a reviewing clinician. It bypasses the correspondence cycle entirely and is often the fastest available route.

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u/maren_sorensen53 points·1 year ago

Disagree with the tone strategy. Anger has never moved a determination; matching the criterion has.

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u/ireland_drugs_pay26 points·1 year ago

Appeal deadlines run from the date on the determination letter. They are strict, they are short, and a missed deadline usually forfeits that level entirely.

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u/appeal_letter_alMOD19 points·1 year ago

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

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u/rekha_mbeki6 points·1 year ago

Employer plan or individual plan?

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u/elin_varga9 points·1 year ago

That advice is jurisdiction-specific and this board spans several. Say where you are.

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u/ines_krastev14 points·1 year ago

document what has been tried and for how long, that is the whole case

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u/muscle_cramp_mo-21 points·1 year ago

This. Step therapy is a paperwork requirement and it is beaten with documentation, not persuasion.

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u/ismael_nwosu0 points·1 year ago

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

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u/maren_ibarra1 point·1 year ago

Not convinced. That is a formulary exclusion rather than a prior authorisation denial, and the route to challenge it is different.

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u/camila_vasquez1 point·1 year ago

ask for the clinical policy bulletin by number

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u/karim_restrepo1 point·1 year ago

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

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u/ines_krastev1 point·1 year ago

Right, and keeping every date and reference number turns a frustrating process into an auditable one.

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u/karim_restrepo10 points·1 year 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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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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