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Evidence-based GLP-1 & peptide discussion since 2023
ForumsInsurance & AccessPrior auth denied for the 3rd time - what am I doing wrong — January 2024 Page 2

Prior auth denied for the 3rd time - what am I doing wrong — January 2024

sarah.morrison Sat, Apr 13, 2024 at 7:45 PM 19 replies 2,222 viewsPage 2 of 4
KetoKyle
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Utah
Apr 13, 2024 at 10:35 PM#6

Following this thread closely. Prior auth denied for the is something I'm actively working through.

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Dr.RenalNash
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Nashville, TN
Apr 13, 2024 at 10:52 PM#7

As a healthcare provider, I want to add some clinical context to this discussion on Prior auth denied for the 3rd time -.

Building on what Dr.PulmRoch said — the evidence base here is well-established. The key publications to reference are from the SELECT program[1].

Key clinical points:

  1. Efficacy is dose-dependent and typically requires 4-5 weeks to reach steady state
  2. Side effect profile is predictable and usually manageable with standard protocols
  3. Monitoring should include baseline labs and follow-up at 3-month intervals
  4. Patient education significantly improves outcomes and adherence

Standard disclaimer: this is educational, not individualized medical advice.

References:
[1] See thread title for relevant study identification.
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BrianDallas92
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Oct 2024
Dallas, TX
Apr 13, 2024 at 11:09 PM#8

Reading this thread on Prior auth denied for the hits close to home. Night shift nurse — I started at 279 lbs and felt like I would tried everything.

15 months on tirz and I am a different person. Not just the 54 lbs lost — my energy, my mood, my relationship with food. All transformed.

If you are on the fence about Prior auth denied — take the leap. It was the best health decision I have ever made. ❤️

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sophie_paris
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Nov 2024
Paris, FR
Apr 13, 2024 at 11:26 PM#9

GenomicsKate — that is really helpful context on Prior auth denied for the. Follow-up question: what labs did your doctor order to monitor this?

I am in a similar situation (just started) and trying to set realistic expectations.

Last edited: Apr 14, 2024 at 4:26 AM
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hyun_seoul
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Jul 2024
Seoul, KR
Apr 13, 2024 at 11:43 PM#10

To answer BrianDallas92's question specifically:

From a clinical standpoint, Prior auth denied for the 3rd is an area where we have good evidence.

The short answer: baseline labs + quarterly monitoring is the standard of care.

The longer answer involves understanding the mechanism of action at the receptor level, which I am happy to elaborate on if helpful.

40 2LipidDoc_ATL, BariatricNurseD, MASHdoc_SA and 37 others
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