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c/insurancefights·submitted 2 years ago by u/nnt_nate

Spain: copay, and what it actually costs here

Discussionbranch of 7 comments

Spain: copay, and what it actually costs here. Not a hot take, just something I have not seen said plainly here. External review was the thing that finally worked. I did not know it existed until a thread on this board. Missed a deadline because I counted from when I opened the envelope. That mistake cost me an…

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7 comments, started 2 years ago
u/sock_puppet_spotter51 points·2 years ago

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

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u/ferran_batista38 points·2 years ago

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.

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[removed]36 points·2 years ago

[removed by moderator]

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u/marta_vanhecke19 points·2 years ago

Yes. Written, always, even when they tell you a phone call is sufficient.

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u/marisol_moreau24 points·2 years ago

Correcting myself upthread: the deadline was 24 days, not the figure I gave.

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u/RetaAndRegret230 points·2 years ago

What exactly does the denial letter give as the reason?

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u/tidy_vialdrawer_watch10 points·2 years ago

a peer-to-peer call is often faster than a written appeal

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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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