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ForumsInsurance & AccessPrior auth denied for the 3rd time - what am I doing wrong — my results so far Page 3

Prior auth denied for the 3rd time - what am I doing wrong — my results so far

PharmD_Rodriguez Fri, Sep 26, 2025 at 2:12 AM 12 replies 1,178 viewsPage 3 of 3
AttorneyGrant
Member
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2,890
Apr 2024
Washington, DC
Sep 26, 2025 at 6:27 AM#11

amy_econ_NJ — wow. This community is amazing.

Last edited: Sep 26, 2025 at 7:27 AM
46 18Dr.SleepRoch, laura_annarbor, JenMemphis and 43 others
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mark_tokyo
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Jun 2024
Tokyo, JP
Sep 26, 2025 at 6:44 AM#12

Slightly tangential to Prior auth denied for the but PharmD_Rodriguez reminded me — what is the latest on the oral formulations?

I know it is not exactly on-topic but it seems related enough to ask here rather than starting a new thread. Apologies if this has been covered — I did search first.

29 5bri_stats, pete_manc_UK, anna.melb_AU and 26 others
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KarenAZ_mom
Member
567
2,567
Aug 2024
Scottsdale, AZ
Sep 26, 2025 at 7:01 AM#13

Thanks for sharing this, PharmD_Rodriguez. A few questions about your Prior auth denied experience:

  1. What dose worked best for you?
  2. How long before you noticed appetite suppression kicking in?
  3. Did your endo have any specific recommendations about Prior auth deni?

I am in a similar boat and trying to learn from others' experiences before my next appointment.

21 20bri_stats, pete_manc_UK, anna.melb_AU and 18 others
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PharmD_Rodriguez
Senior Member
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14,567
Jan 2024
Miami, FL
Sep 26, 2025 at 7:18 AM#14

OP here — wow, did not expect this much response! Thank you all for the thoughtful replies on Prior auth denied for the.

To answer mark_tokyo: yes, I am on compounded sema from a 503B pharmacy.

Quick update: things are still going well. Thanks again for the evidence-based discussion — this is exactly why I posted in a science-based community. 🙏

47 2dan_philly, MeganSA_TX, LarryQC_SD and 44 others
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stefan_berlin
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1,123
Oct 2024
Berlin, DE
Sep 26, 2025 at 7:35 AM#15

Relevant to Prior auth denied for the 3rd — here is my latest bloodwork comparison:

Key improvements: A1C 8.4% → 5.5%, triglycerides 245 → 115 mg/dL, hsCRP 8.0 → 0.9 mg/L. All on tirzepatide for 13 months.

The inflammatory marker drop is what impresses me most. Consistent with the SELECT trial's cardiovascular findings.

Last edited: Sep 26, 2025 at 10:35 AM
14 20TrialTracker_MD, JennaRN, LabKate and 11 others
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