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ForumsInsurance & Access2026 payer coverage update — GLP-1 formulary changes by insurer Page 20

2026 payer coverage update — GLP-1 formulary changes by insurer

InsuranceTom Mon, Feb 26, 2024 at 4:00 PM 377 replies 33,823 viewsPage 20 of 20
mike.trainer_LA
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Jul 9, 2024 at 3:57 PM#96
FDA_TrackerJim said:
Denials are usually procedural rather than clinical, and the order that works reflects that.

Fair, and it stops being fair at the extremes. The middle of the range is well understood; the ends are where the honest answer is that nobody knows.

44 17Dr.AddMedPHL, newstart_MO, mia_MS2 and 41 others
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PeptideSynthNJ
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Jul 11, 2024 at 7:05 AM#97
FDA_TrackerJim said:
Denials are usually procedural rather than clinical, and the order that works reflects that.

Saving this. It is the first explanation that did not require me to already understand it.

45 18NurseAsh_DET, BenResearch_OR, MikeKY_noInsulin and 42 others
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InsuranceTom
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Jul 12, 2024 at 10:12 PM#98

OP back with an update, since a thread like this is useless without one.

Reporting back for the archive rather than for the thread: I did the narrow version of what was suggested, gave it the full interval, and it settled. Posting it because threads without a follow-up are half a thread.

46 19Dr.ReproEndo, lucas_SP_BR, lisa_labSD and 43 others
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dave_SLC
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Jul 14, 2024 at 1:18 PM#99
InsuranceTom said:
Reporting back for the archive rather than for the thread: I did the narrow version of what was suggested, gave it the full interval, and it settled.

Second this.

47 20FranDenver, Dr.BariatricHTX, LindaRN_retired and 44 others
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DataDave
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Jul 16, 2024 at 4:23 AM#100
InsuranceTom said:
Reporting back for the archive rather than for the thread: I did the narrow version of what was suggested, gave it the full interval, and it settled.

Worth restating a point from upthread for anyone joining at this page:

This treats a plausible mechanism as a demonstrated one. Plausible is where you start looking, not where you stop.

20 0Dr.GutHealth, amsterdam_pete, LondonLisa and 17 others
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