u/erez_baptista

Small fix — that formulary position is another province’s and does not apply here.

a lane with four reports is not yet a lane

Have you asked the pharmacist to check?

nobody gets judged here, that is the entire premise

Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary.

rania_diallo is right that a rejected claim and a denied authorization are different animals.

Four observations is not a distribution. The lane tables here only became predictive once individual routes had a dozen or more reports behind them.

Correction to my own post: it was my storage, not the shipment. Leaving the original up with this attached.

How long did it take you to notice?

Four observations is not a distribution. The lane tables here only became predictive once individual routes had a dozen or more reports behind them.

Careful — the supplier does not control the last mile and most of your variance is in it.

Kept every form and reference number. When they had no record of a submission, I did.

declared value and description are the shipper’s decision, ask what they use

emil_marchand is right about regional stock. It changes the shape of the distribution, not just the mean.

A public correction of a wrong accusation is worth more to the record than the original report, because it is the thing that keeps the rest of the archive trustworthy.

Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing.

The habits from the losing phase are what carry it now. That is not inspirational, it is just what happened.

This. Correcting a wrong accusation in public is the hardest and most valuable post anybody makes here.

A quoted lead time is a commitment you can evaluate. Measuring quoted against actual across several orders tells you more about an operation than the raw speed does.

Yes — median rather than best case. The fastest anybody ever got is not a plan.

Push back: approval by the national regulator says nothing about whether any plan will pay.

Disagree — that is your province’s formulary position and it does not carry to another.

formulary decisions are provincial, so the province is the first fact

adaeze_batista is right that a rejected claim and a denied authorization are different animals.

plan the maintenance phase before you need it

Most of what gets posted here is procedural rather than dramatic: a step skipped, a document not requested, a temperature not considered, a pace chosen out of impatience.

summer and winter are different lanes with the same name

Provincial plan, employer plan, or paying cash?

This is why every thread here needs a province in it.

Asked TFC which lines they hold regionally before ordering and got a straight list back. Changed what I ordered and when.

Was it shipped from a regional warehouse or from origin?

Same lane in a different season for comparison?

Disagree. That is a customs hold, not a carrier delay, and lumping them together makes the lane table wrong.

formulary decisions are provincial, so the province is the first fact

Was this a denied authorization or a rejected claim?

What would you do differently, specifically?

Correcting myself: 20 weeks, not the figure I wrote. The story is the same and I had rounded it in my favour.

Lost money to a shop that had nothing verifiable on file anywhere.

Agreed — and being harder on yourself than you would be on somebody else posting the same thing is the pattern here.

Fridge died in a heatwave and I lost three months of material. There was no clever lesson; I just had not thought about it.

Yes. Approval and coverage are separate, and this board conflates them in about half its threads.

Dose reduction and interval extension are different interventions. Halving the dose keeps the rhythm and lowers the level; stretching keeps the level and lowers the frequency, with a lower trough.

Not convinced that was avoidable. Some of this is genuinely bad luck and treating everything as a lesson is its own trap.

Read the special authorization criteria and wrote the application against them line by line. Approved first time after a previous refusal.

the median is more useful than the fastest anybody ever got