Dr.SportsMedIN said:It is worth asking what the claim would look like if it were false.
That holds where the measurement is reliable. Where it is noisy — and a lot of what gets tracked here is noisy — the same reasoning produces confident nonsense.
DeniseRN_TPA said:Agreed, and coverage criteria are plan-specific rather than insurer-specific.
Saving this. It is the first explanation that did not require me to already understand it.
Dr.SportsMedIN said:It is worth asking what the claim would look like if it were false.
I read this differently from Dr.SportsMedIN, on substance rather than tone. The affordability discussion here usually stops at individual tactics. At list price this class is out of reach for most of the people who would benefit, and no amount of appeal strategy changes that — it is a pricing problem wearing a paperwork costume.
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Shop Reference StandardsThe figures, for anyone assembling their own picture. For anyone reading later: the numbers in this thread are worth checking against a primary source before you act on them, including mine. Half the figures circulating in this community trace back to a secondary summary that dropped a qualifier.