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ForumsInsurance & AccessPrior auth denied for the 3rd time - what am I doing wrong — January 2024 Page 3

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 3 of 4
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Apr 14, 2024 at 12:00 AM#11

Moderator note: Great discussion, everyone. Just a reminder to keep things civil and evidence-based.

Thread quality is excellent — keep it up. 👍

30 12PedsEndoPhilly, SleepDoc_PDX, RegAffairsDC and 27 others
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Dr.SurgeonPGH
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Apr 14, 2024 at 12:17 AM#12

Slightly tangential to Prior auth denied for the but LabKate reminded me — has the insurance landscape changed recently?

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.

Last edited: Apr 14, 2024 at 3:17 AM
1 2TomTeleRx
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dan_philly
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Apr 14, 2024 at 12:34 AM#13
sophie_paris said:
Follow-up question: what labs did your doctor order to monitor this

This is exactly right. sophie_paris articulated what I have been trying to explain to my friends for months. The Prior auth denied for the aspect is what made the difference for me.

Last edited: Apr 14, 2024 at 3:34 AM
26 13SkepticalSean, Dr.CardioMD, EndoResFellow and 23 others
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mike_mealprep
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Apr 14, 2024 at 12:51 AM#14

Saving this for reference. Quality thread.

Last edited: Apr 14, 2024 at 6:51 AM
45 12mel_PDX, Dr.AddMedPHL, newstart_MO and 42 others
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HPLC_Greg
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Apr 14, 2024 at 1:08 AM#15

Adding my data to this Prior auth denied for the discussion:

MetricBaselineMonth 3Month 6
Weight276 lbs216 lbs201 lbs
A1C7.0%5.8%5.2%
hsCRP5.02.01.0

Protocol: Semaglutide 2.4mg/wk, resistance training 3x/wk, protein 1.3g/kg/day.

Last edited: Apr 14, 2024 at 7:08 AM
8 9SaraMom3, Dr.MetabolicMD, RetaRick_CA and 5 others
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