[Meta] proposal — a flair for appeal posts
proposal — a flair for appeal posts. This affects how posts get sorted and removed, so it belongs in the open. Asked for the policy bulletin by number and wrote the appeal against its criteria line by line. Approved on the second level after a flat first-level denial. Employer-sponsored plans may be regulated…
Agreed. The denial letter tells you which criterion failed, and answering that specific criterion is the entire job.
That criterion is from the previous plan year. The current bulletin has different wording.
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.
a template letter that quotes their own criteria back is the strongest one
That advice is jurisdiction-specific and this board spans several. Say where you are.