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#payer-escalations

Urgent PA denials, appeals routing

C07ESCAL04
632 msgs in channel · showing recent 250 + 1 storyline
AB
Aisha BelloThu Jan 1, 11:14 AM
Appeals turnaround at Cigna now 6d. Escalating.
BO
Ben OrtizThu Jan 1, 11:51 AM
Escalating UHC PA latency — pulling a payer call for Wed.
AB
Aisha BelloThu Jan 1, 2:01 PM
Appeals turnaround at Aetna now 6d. Escalating.
LC
Lila ChenThu Jan 1, 6:30 PM
Denial #8 from Aetna in Southeast — pulling case for appeal.
LC
Lila ChenFri Jan 1, 8:26 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
VI
Vikram IyerFri Jan 1, 8:37 PM
Appeals turnaround at Humana now 9d. Escalating.
MR
Marco ReyesSun Jan 3, 8:21 PM
Express Scripts medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloTue Jan 6, 3:29 PM
Case #36: PA denied on PD-L1 threshold; ordering reflex test.
BO
Ben OrtizWed Jan 6, 7:51 PM
53 appeals approved this week — running rate up.
BO
Ben OrtizWed Jan 7, 3:44 PM
Express Scripts medical-director call next Tuesday — drafting talking points.
MR
Marco ReyesWed Jan 7, 5:08 PM
Appeals turnaround at Humana now 3d. Escalating.
LC
Lila ChenThu Jan 7, 8:15 PM
Appeals turnaround at OptumRx now 6d. Escalating.
VI
Vikram IyerThu Jan 8, 11:53 AM
Case #8: PA denied on PD-L1 threshold; ordering reflex test.
MR
Marco ReyesFri Jan 8, 8:14 PM
PA approval flipped to denial on resubmit at Aetna — case @priya.
BO
Ben OrtizFri Jan 9, 1:24 PM
Pulled together the Cigna denial-rate trend; sharing in DM.
LC
Lila ChenFri Jan 9, 1:47 PM
Pulled together the OptumRx denial-rate trend; sharing in DM.
LC
Lila ChenSat Jan 9, 7:38 PM
Express Scripts medical-director call next Tuesday — drafting talking points.
LC
Lila ChenSat Jan 9, 7:47 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizSun Jan 11, 11:35 AM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
MR
Marco ReyesTue Jan 13, 6:45 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizTue Jan 13, 6:51 PM
Three patients in West stuck behind Cigna step-edit since Jan 7.
VI
Vikram IyerWed Jan 13, 7:27 PM
Cigna 4-day → 9-day PA decision shift. Anyone else seeing this?
MR
Marco ReyesWed Jan 14, 11:52 AM
PA approval flipped to denial on resubmit at Humana — case @priya.
AB
Aisha BelloWed Jan 14, 4:17 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
LC
Lila ChenThu Jan 15, 11:15 AM
Denial #24 from Anthem in Northeast — pulling case for appeal.
VI
Vikram IyerThu Jan 15, 4:39 PM
Escalating UHC PA latency — pulling a payer call for Wed.
LC
Lila ChenThu Jan 15, 4:46 PM
BCBS-IL 4-day → 5-day PA decision shift. Anyone else seeing this?
VI
Vikram IyerThu Jan 15, 5:45 PM
Denial #29 from BCBS-IL in Northeast — pulling case for appeal.
MR
Marco ReyesSat Jan 17, 12:55 PM
Appeals turnaround at Express Scripts now 6d. Escalating.
MR
Marco ReyesSat Jan 17, 2:42 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
MR
Marco ReyesSun Jan 17, 7:53 PM
Three patients in West stuck behind Express Scripts step-edit since Dec 30.
AB
Aisha BelloTue Jan 20, 12:26 PM
Pulled together the BCBS-IL denial-rate trend; sharing in DM.
MR
Marco ReyesWed Jan 21, 1:56 PM
8 appeals approved this week — running rate up.
MR
Marco ReyesThu Jan 21, 7:43 PM
56 appeals approved this week — running rate up.
AB
Aisha BelloThu Jan 22, 12:39 PM
Case #15: PA denied on PD-L1 threshold; ordering reflex test.
AB
Aisha BelloThu Jan 22, 12:39 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
MR
Marco ReyesThu Jan 22, 4:00 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
VI
Vikram IyerFri Jan 23, 11:53 AM
Escalating UHC PA latency — pulling a payer call for Wed.
BO
Ben OrtizFri Jan 23, 5:08 PM
Three patients in West stuck behind Aetna step-edit since Jan 20.
VI
Vikram IyerFri Jan 23, 6:50 PM
Case #19: PA denied on PD-L1 threshold; ordering reflex test.
LC
Lila ChenSat Jan 24, 1:21 PM
PA approval flipped to denial on resubmit at Aetna — case @tony.
BO
Ben OrtizTue Jan 27, 2:06 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerTue Jan 27, 3:32 PM
Case #60: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerWed Jan 28, 11:25 AM
Escalating UHC PA latency — pulling a payer call for Wed.
LC
Lila ChenWed Jan 28, 1:31 PM
Appeals turnaround at Express Scripts now 9d. Escalating.
MR
Marco ReyesThu Jan 28, 7:11 PM
Pulled together the Cigna denial-rate trend; sharing in DM.
MR
Marco ReyesThu Jan 29, 1:46 PM
Three patients in Northeast stuck behind Anthem step-edit since Jan 16.
MR
Marco ReyesThu Jan 29, 6:03 PM
Denial #32 from Anthem in East — pulling case for appeal.
AB
Aisha BelloThu Jan 29, 6:56 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
LC
Lila ChenSat Jan 30, 8:44 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
MR
Marco ReyesSat Jan 31, 12:56 PM
Escalating UHC PA latency — pulling a payer call for Wed.
VI
Vikram IyerSat Jan 31, 2:49 PM
Case #38: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerTue Feb 3, 12:36 PM
Escalating UHC PA latency — pulling a payer call for Wed.
LC
Lila ChenTue Feb 3, 2:12 PM
BCBS-IL medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloTue Feb 3, 2:40 PM
PA approval flipped to denial on resubmit at OptumRx — case @priya.
VI
Vikram IyerWed Feb 4, 11:54 AM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerWed Feb 4, 6:52 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerThu Feb 5, 5:46 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizSun Feb 7, 8:05 PM
Three patients in East stuck behind Express Scripts step-edit since Feb 2.
AB
Aisha BelloSun Feb 8, 4:03 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
LC
Lila ChenMon Feb 9, 5:00 PM
2 appeals approved this week — running rate up.
AB
Aisha BelloTue Feb 10, 2:49 PM
Three patients in East stuck behind Express Scripts step-edit since Feb 10.
BO
Ben OrtizWed Feb 10, 7:35 PM
PA approval flipped to denial on resubmit at Cigna — case @megan.
AB
Aisha BelloFri Feb 12, 7:24 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
MR
Marco ReyesFri Feb 13, 2:25 PM
Case #10: PA denied on PD-L1 threshold; ordering reflex test.
BO
Ben OrtizFri Feb 13, 4:29 PM
Anthem 4-day → 6-day PA decision shift. Anyone else seeing this?
AB
Aisha BelloSat Feb 14, 11:07 AM
Pulled together the BCBS-IL denial-rate trend; sharing in DM.
VI
Vikram IyerSat Feb 14, 12:09 PM
34 appeals approved this week — running rate up.
LC
Lila ChenTue Feb 16, 7:15 PM
Escalating UHC PA latency — pulling a payer call for Wed.
VI
Vikram IyerTue Feb 16, 8:59 PM
Denial #46 from OptumRx in Midwest — pulling case for appeal.
BO
Ben OrtizTue Feb 17, 1:18 PM
Case #40: PA denied on PD-L1 threshold; ordering reflex test.
LC
Lila ChenTue Feb 17, 3:10 PM
BCBS-IL medical-director call next Tuesday — drafting talking points.
LC
Lila ChenWed Feb 17, 8:17 PM
Denial #20 from BCBS-IL in West — pulling case for appeal.
BO
Ben OrtizWed Feb 18, 11:54 AM
Escalating UHC PA latency — pulling a payer call for Wed.
LC
Lila ChenWed Feb 18, 12:52 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerThu Feb 19, 1:20 PM
48 appeals approved this week — running rate up.
MR
Marco ReyesFri Feb 19, 7:40 PM
Case #51: PA denied on PD-L1 threshold; ordering reflex test.
AB
Aisha BelloFri Feb 20, 12:09 PM
Denial #63 from Aetna in Midwest — pulling case for appeal.
MR
Marco ReyesSat Feb 21, 12:22 PM
81 appeals approved this week — running rate up.
MR
Marco ReyesWed Feb 24, 7:25 PM
BCBS-IL medical-director call next Tuesday — drafting talking points.
VI
Vikram IyerWed Feb 24, 8:04 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
AB
Aisha BelloWed Feb 25, 4:16 PM
Appeals turnaround at Humana now 9d. Escalating.
LC
Lila ChenWed Feb 25, 4:38 PM
PA approval flipped to denial on resubmit at UHC — case @megan.
VI
Vikram IyerThu Feb 26, 4:56 PM
Case #79: PA denied on PD-L1 threshold; ordering reflex test.
MR
Marco ReyesFri Feb 27, 12:07 PM
Case #76: PA denied on PD-L1 threshold; ordering reflex test.
LC
Lila ChenSat Feb 28, 5:52 PM
Anthem 4-day → 5-day PA decision shift. Anyone else seeing this?
AB
Aisha BelloSat Feb 28, 6:54 PM
Case #8: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerTue Mar 3, 12:05 PM
UHC medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloTue Mar 3, 12:17 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
MR
Marco ReyesTue Mar 3, 6:17 PM
Denial #24 from Anthem in Northeast — pulling case for appeal.
VI
Vikram IyerWed Mar 4, 5:16 PM
Pulled together the BCBS-IL denial-rate trend; sharing in DM.
AB
Aisha BelloFri Mar 5, 7:39 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
VI
Vikram IyerFri Mar 6, 6:59 PM
Pulled together the BCBS-IL denial-rate trend; sharing in DM.
LC
Lila ChenSat Mar 7, 12:17 PM
Three patients in Northeast stuck behind UHC step-edit since Feb 17.
BO
Ben OrtizSat Mar 7, 5:10 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
MR
Marco ReyesSun Mar 8, 3:30 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerMon Mar 9, 1:00 PM
Case #21: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerTue Mar 10, 2:58 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizTue Mar 10, 3:58 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
LC
Lila ChenTue Mar 10, 7:48 PM
PA approval flipped to denial on resubmit at Humana — case @tony.
MR
Marco ReyesThu Mar 11, 8:53 PM
Aetna medical-director call next Tuesday — drafting talking points.
BO
Ben OrtizThu Mar 12, 1:04 PM
47 appeals approved this week — running rate up.
LC
Lila ChenThu Mar 12, 5:58 PM
Appeals turnaround at Anthem now 9d. Escalating.
BO
Ben OrtizFri Mar 13, 3:42 PM
Case #69: PA denied on PD-L1 threshold; ordering reflex test.
LC
Lila ChenFri Mar 13, 3:52 PM
PA approval flipped to denial on resubmit at Humana — case @sofia.
BO
Ben OrtizSat Mar 14, 2:08 PM
Pulled together the Cigna denial-rate trend; sharing in DM.
MR
Marco ReyesSat Mar 14, 2:44 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizSun Mar 15, 6:09 PM
27 appeals approved this week — running rate up.
AB
Aisha BelloTue Mar 17, 5:36 PM
Appeals turnaround at Aetna now 8d. Escalating.
AB
Aisha BelloThu Mar 18, 8:52 PM
UHC 4-day → 4-day PA decision shift. Anyone else seeing this?
MR
Marco ReyesThu Mar 19, 12:51 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerThu Mar 19, 4:40 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
LC
Lila ChenFri Mar 20, 2:14 PM
UHC medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloFri Mar 20, 6:26 PM
Express Scripts medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloFri Mar 20, 6:42 PM
Case #2: PA denied on PD-L1 threshold; ordering reflex test.
LC
Lila ChenSat Mar 20, 8:36 PM
Denial #55 from Humana in East — pulling case for appeal.
BO
Ben OrtizSat Mar 21, 1:12 PM
Case #58: PA denied on PD-L1 threshold; ordering reflex test.
MR
Marco ReyesSun Mar 22, 2:09 PM
Appeals turnaround at OptumRx now 2d. Escalating.
LC
Lila ChenTue Mar 24, 12:02 PM
PA approval flipped to denial on resubmit at Express Scripts — case @priya.
AB
Aisha BelloWed Mar 25, 12:35 PM
Denial #16 from BCBS-IL in Northeast — pulling case for appeal.
VI
Vikram IyerWed Mar 25, 2:09 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
MR
Marco ReyesThu Mar 26, 4:28 PM
Denial #80 from Express Scripts in Southeast — pulling case for appeal.
AB
Aisha BelloThu Mar 26, 6:58 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerFri Mar 27, 2:53 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerFri Mar 27, 3:45 PM
PA approval flipped to denial on resubmit at Cigna — case @dev.
LC
Lila ChenSat Mar 28, 2:59 PM
Escalating UHC PA latency — pulling a payer call for Wed.
LC
Lila ChenSun Mar 28, 9:40 PM
80 appeals approved this week — running rate up.
LC
Lila ChenTue Mar 30, 9:21 PM
42 appeals approved this week — running rate up.
AB
Aisha BelloTue Mar 31, 7:18 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
AB
Aisha BelloWed Apr 1, 4:55 PM
Three patients in Southeast stuck behind Aetna step-edit since Mar 18.
LC
Lila ChenWed Apr 1, 6:42 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
BO
Ben OrtizThu Apr 1, 8:16 PM
Case #69: PA denied on PD-L1 threshold; ordering reflex test.
LC
Lila ChenThu Apr 2, 12:57 PM
9 appeals approved this week — running rate up.
BO
Ben OrtizThu Apr 2, 5:30 PM
Denial #3 from Humana in East — pulling case for appeal.
BO
Ben OrtizThu Apr 2, 5:49 PM
Cigna medical-director call next Tuesday — drafting talking points.
VI
Vikram IyerFri Apr 3, 1:50 PM
27 appeals approved this week — running rate up.
BO
Ben OrtizSat Apr 3, 8:32 PM
Denial #50 from Express Scripts in Northeast — pulling case for appeal.
BO
Ben OrtizSat Apr 4, 3:52 PM
Anthem medical-director call next Tuesday — drafting talking points.
BO
Ben OrtizSat Apr 4, 5:59 PM
Three patients in Southeast stuck behind OptumRx step-edit since Mar 28.
AB
Aisha BelloSun Apr 5, 1:25 PM
Case #68: PA denied on PD-L1 threshold; ordering reflex test.
AB
Aisha BelloTue Apr 7, 5:19 PM
Anthem 4-day → 7-day PA decision shift. Anyone else seeing this?
BO
Ben OrtizWed Apr 7, 8:43 PM
Anthem 4-day → 4-day PA decision shift. Anyone else seeing this?
VI
Vikram IyerWed Apr 8, 1:26 PM
Case #21: PA denied on PD-L1 threshold; ordering reflex test.
MR
Marco ReyesThu Apr 8, 9:16 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerThu Apr 8, 9:28 PM
Case #28: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerFri Apr 9, 9:35 PM
Denial #53 from Cigna in East — pulling case for appeal.
AB
Aisha BelloFri Apr 10, 12:01 PM
OptumRx 4-day → 2-day PA decision shift. Anyone else seeing this?
MR
Marco ReyesFri Apr 10, 4:49 PM
Denial #4 from UHC in Southeast — pulling case for appeal.
VI
Vikram IyerSun Apr 11, 8:17 PM
Pulled together the Anthem denial-rate trend; sharing in DM.
AB
Aisha BelloMon Apr 13, 4:20 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
BO
Ben OrtizMon Apr 13, 5:16 PM
Pulled together the UHC denial-rate trend; sharing in DM.
MR
Marco ReyesTue Apr 14, 1:03 PM
PA approval flipped to denial on resubmit at UHC — case @priya.
BO
Ben OrtizTue Apr 14, 2:06 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
BO
Ben OrtizWed Apr 14, 9:18 PM
Pulled together the UHC denial-rate trend; sharing in DM.
MR
Marco ReyesFri Apr 16, 9:27 PM
PA approval flipped to denial on resubmit at Humana — case @sofia.
BO
Ben OrtizFri Apr 17, 2:00 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
BO
Ben OrtizFri Apr 17, 6:40 PM
PA approval flipped to denial on resubmit at Express Scripts — case @megan.
LC
Lila ChenSun Apr 18, 8:17 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerSun Apr 18, 9:47 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
MR
Marco ReyesSun Apr 19, 7:34 PM
Case #74: PA denied on PD-L1 threshold; ordering reflex test.
MR
Marco ReyesTue Apr 21, 6:26 PM
81 appeals approved this week — running rate up.
BO
Ben OrtizTue Apr 21, 6:36 PM
48 appeals approved this week — running rate up.
BO
Ben OrtizTue Apr 21, 7:07 PM
PA approval flipped to denial on resubmit at Humana — case @dev.
MR
Marco ReyesTue Apr 21, 7:20 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
AB
Aisha BelloWed Apr 22, 7:40 PM
Humana medical-director call next Tuesday — drafting talking points.
VI
Vikram IyerThu Apr 23, 12:37 PM
Denial #8 from Humana in Southeast — pulling case for appeal.
MR
Marco ReyesFri Apr 24, 1:43 PM
BCBS-IL medical-director call next Tuesday — drafting talking points.
MR
Marco ReyesSat Apr 24, 9:13 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
AB
Aisha BelloSat Apr 24, 9:48 PM
Appeals turnaround at UHC now 7d. Escalating.
LC
Lila ChenSat Apr 25, 6:01 PM
PA approval flipped to denial on resubmit at Humana — case @tony.
MR
Marco ReyesSat Apr 25, 6:47 PM
PA approval flipped to denial on resubmit at Humana — case @megan.
BO
Ben OrtizSun Apr 25, 9:11 PM
Anthem medical-director call next Tuesday — drafting talking points.
MR
Marco ReyesTue Apr 28, 3:01 PM
PA approval flipped to denial on resubmit at Aetna — case @sofia.
BO
Ben OrtizTue Apr 28, 6:42 PM
Express Scripts medical-director call next Tuesday — drafting talking points.
LC
Lila ChenTue Apr 28, 7:03 PM
Three patients in East stuck behind Aetna step-edit since Apr 14.
BO
Ben OrtizWed Apr 28, 9:43 PM
24 appeals approved this week — running rate up.
AB
Aisha BelloWed Apr 29, 2:29 PM
Appeals turnaround at Express Scripts now 4d. Escalating.
VI
Vikram IyerThu Apr 30, 4:35 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
LC
Lila ChenFri Apr 30, 9:01 PM
Cigna 4-day → 5-day PA decision shift. Anyone else seeing this?
MR
Marco ReyesSat May 2, 2:39 PM
Appeals turnaround at Anthem now 2d. Escalating.
BO
Ben OrtizSat May 2, 5:21 PM
BCBS-IL 4-day → 7-day PA decision shift. Anyone else seeing this?
AB
Aisha BelloMon May 3, 8:29 PM
Pulled together the Cigna denial-rate trend; sharing in DM.
VI
Vikram IyerTue May 5, 12:56 PM
4 appeals approved this week — running rate up.
LC
Lila ChenTue May 5, 2:46 PM
Case #4: PA denied on PD-L1 threshold; ordering reflex test.
BO
Ben OrtizTue May 5, 4:03 PM
76 appeals approved this week — running rate up.
LC
Lila ChenWed May 5, 8:53 PM
Denial #18 from UHC in West — pulling case for appeal.
MR
Marco ReyesWed May 6, 7:30 PM
Aetna 4-day → 2-day PA decision shift. Anyone else seeing this?
LC
Lila ChenThu May 6, 8:22 PM
Cigna 4-day → 7-day PA decision shift. Anyone else seeing this?
BO
Ben OrtizSat May 8, 8:38 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
BO
Ben OrtizSat May 9, 6:37 PM
Case #59: PA denied on PD-L1 threshold; ordering reflex test.
AB
Aisha BelloMon May 11, 9:15 AMarc: uhc-pa-escalation
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this? — Aisha kicks off the escalation thread in #payer-escalations after a Monday call run from Ben's reps.
BO
Ben OrtizMon May 11, 9:18 AM
Confirmed, 4 of my reps flagged Friday.
MR
Marco ReyesMon May 11, 9:25 AM
Escalating — pulling a payer call for Wed.
:raised_hands: 2
LC
Lila ChenTue May 12, 3:32 PM
Aetna 4-day → 3-day PA decision shift. Anyone else seeing this?
VI
Vikram IyerTue May 12, 6:13 PM
Pulled together the UHC denial-rate trend; sharing in DM.
LC
Lila ChenWed May 12, 9:14 PM
Anthem medical-director call next Tuesday — drafting talking points.
VI
Vikram IyerWed May 13, 3:36 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
VI
Vikram IyerWed May 13, 6:14 PM
Case #71: PA denied on PD-L1 threshold; ordering reflex test.
BO
Ben OrtizThu May 13, 8:19 PM
Pulled together the Humana denial-rate trend; sharing in DM.
LC
Lila ChenFri May 15, 7:38 PM
Pulled together the OptumRx denial-rate trend; sharing in DM.
MR
Marco ReyesSat May 16, 1:46 PM
Appeals turnaround at Express Scripts now 5d. Escalating.
VI
Vikram IyerTue May 19, 6:04 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerTue May 19, 6:57 PM
Case #51: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerWed May 20, 12:25 PM
Escalating UHC PA latency — pulling a payer call for Wed.
VI
Vikram IyerWed May 20, 1:58 PM
42 appeals approved this week — running rate up.
MR
Marco ReyesWed May 20, 6:50 PM
Aetna 4-day → 7-day PA decision shift. Anyone else seeing this?
BO
Ben OrtizThu May 20, 8:10 PM
Three patients in Midwest stuck behind Anthem step-edit since May 9.
AB
Aisha BelloThu May 21, 2:08 PM
PA approval flipped to denial on resubmit at Humana — case @dev.
AB
Aisha BelloFri May 21, 8:28 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
MR
Marco ReyesFri May 22, 4:54 PM
Three patients in Northeast stuck behind Express Scripts step-edit since May 5.
LC
Lila ChenFri May 22, 7:16 PM
Case #6: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerSat May 23, 12:21 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerSat May 23, 3:42 PM
Three patients in East stuck behind UHC step-edit since May 10.
BO
Ben OrtizTue May 26, 2:00 PM
69 appeals approved this week — running rate up.
VI
Vikram IyerTue May 26, 7:00 PM
Pulled together the Anthem denial-rate trend; sharing in DM.
MR
Marco ReyesWed May 26, 8:00 PM
Denial #80 from UHC in East — pulling case for appeal.
MR
Marco ReyesWed May 27, 2:45 PM
Three patients in West stuck behind UHC step-edit since May 26.
LC
Lila ChenThu May 27, 8:45 PM
PA approval flipped to denial on resubmit at Anthem — case @dev.
AB
Aisha BelloThu May 28, 3:17 PM
Appeals turnaround at OptumRx now 2d. Escalating.
MR
Marco ReyesFri May 29, 2:11 PM
Cigna medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloFri May 29, 3:13 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
AB
Aisha BelloSat May 30, 12:06 PM
PA approval flipped to denial on resubmit at OptumRx — case @sofia.
BO
Ben OrtizSat May 30, 6:09 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
VI
Vikram IyerTue Jun 2, 4:06 PM
23 appeals approved this week — running rate up.
AB
Aisha BelloWed Jun 3, 3:08 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
BO
Ben OrtizWed Jun 3, 6:48 PM
14 appeals approved this week — running rate up.
BO
Ben OrtizThu Jun 4, 1:31 PM
Pulled together the UHC denial-rate trend; sharing in DM.
VI
Vikram IyerThu Jun 4, 3:19 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
LC
Lila ChenFri Jun 4, 9:42 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
BO
Ben OrtizFri Jun 5, 3:26 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
BO
Ben OrtizSat Jun 6, 6:06 PM
Anthem denied 12 patients in TX last week. Pulling case notes.
LC
Lila ChenSat Jun 6, 6:41 PM
Three patients in Midwest stuck behind OptumRx step-edit since Jun 2.
BO
Ben OrtizTue Jun 9, 1:25 PM
Case #83: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerTue Jun 9, 7:23 PM
Three patients in West stuck behind Anthem step-edit since Jun 3.
BO
Ben OrtizWed Jun 9, 8:12 PM
PA approval flipped to denial on resubmit at BCBS-IL — case @tony.
MR
Marco ReyesWed Jun 10, 4:52 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
MR
Marco ReyesWed Jun 10, 6:22 PM
Cigna 4-day → 7-day PA decision shift. Anyone else seeing this?
AB
Aisha BelloThu Jun 11, 2:59 PM
Three patients in Southeast stuck behind Humana step-edit since May 29.
BO
Ben OrtizThu Jun 11, 3:44 PM
PA approval flipped to denial on resubmit at Express Scripts — case @priya.
AB
Aisha BelloFri Jun 12, 2:13 PM
BCBS-IL medical-director call next Tuesday — drafting talking points.
AB
Aisha BelloSat Jun 13, 3:15 PM
Three patients in Southeast stuck behind BCBS-IL step-edit since Jun 9.
LC
Lila ChenSat Jun 13, 6:58 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
VI
Vikram IyerTue Jun 16, 3:48 PM
Denial #41 from OptumRx in Northeast — pulling case for appeal.
LC
Lila ChenTue Jun 16, 7:02 PM
Three patients in Northeast stuck behind OptumRx step-edit since Jun 7.
LC
Lila ChenTue Jun 16, 7:36 PM
UHC PA turnaround slipped to 9 days in NE region — anyone else seeing this?
AB
Aisha BelloTue Jun 16, 7:59 PM
Appeals turnaround at Cigna now 4d. Escalating.
BO
Ben OrtizWed Jun 17, 3:56 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizWed Jun 17, 7:43 PM
Humana medical-director call next Tuesday — drafting talking points.
LC
Lila ChenWed Jun 17, 7:58 PM
Humana 4-day → 2-day PA decision shift. Anyone else seeing this?
LC
Lila ChenThu Jun 18, 1:59 PM
Specialty pharmacy abandoned the script — patient lost to follow-up.
BO
Ben OrtizThu Jun 18, 6:26 PM
Express Scripts medical-director call next Tuesday — drafting talking points.
BO
Ben OrtizFri Jun 19, 12:49 PM
Case #75: PA denied on PD-L1 threshold; ordering reflex test.
VI
Vikram IyerSat Jun 19, 9:22 PM
Cigna medical-director call next Tuesday — drafting talking points.