Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the talking.
What I am trying to establish is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work.
Happy to be told the question itself is wrong.
FDA_TrackerJim said:Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…
Financial impact of cost and coverage weight loss beyond medication cost:
- Groceries: SAVED $218/month (eating less)
- Restaurants: SAVED $208/month (fewer meals out)
- Alcohol: SAVED $158/month (stopped drinking)
- Life insurance: Premium REDUCED by $48/month (lower BMI)
- Copays: SAVED $58/month (fewer BP/cholesterol meds)
Net impact after medication cost: approximately BREAKING EVEN. The medication pays for itself through reduced food spending and healthcare costs. This surprised me.
Dr.GastroMayo said:Financial impact of cost and coverage weight loss beyond medication cost: Groceries: SAVED $218/month (eating less) Restaurants: SAVED $208/month…
Telehealth prescriber review for cost and coverage: I've used 3 different telehealth platforms to get my GLP-1 prescription. Comparison:
| Feature | Platform A | Platform B | Platform C |
|---|---|---|---|
| Initial Consult | $49 | $79 | $0 |
| Monthly Follow-up | $29 | Included | $49 |
| Prescription Speed | Same day | 24-48 hours | Same day |
| Lab Monitoring | Required | Optional | Required |
I settled on the one that required labs — it shows they care about safety, not just prescribing volume.
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Browse GL BiochemFDA_TrackerJim said:Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…
Adding a me-too, because a thread of one person's experience is not much use. Posting only so the count is not one.
Adding the clinical framing, because it changes how the question reads.
My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.