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Telehealth prescriber directory — what worked for you?

FDA_TrackerJim Mon, Nov 11, 2024 at 4:48 PM 14 replies 1,866 viewsPage 1 of 3
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FDA_TrackerJim
Senior Member
1,567
7,890
Feb 2024
Rockville, MD
Nov 11, 2024 at 4:48 PM#1

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.

34 4Dr.Martinez, mike_mod, SarahChen_PharmD and 31 others
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Dr.GastroMayo
VIP Member
2,345
13,456
Jan 2024
Mayo Clinic, MN
Nov 11, 2024 at 4:55 PM#2
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.

33 3VendorMark, COA_Karl, MikeFit_NJ and 30 others
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MikeNYC_runner
Member
378
1,678
Jul 2024
New York, NY
Nov 11, 2024 at 5:02 PM#3
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:

FeaturePlatform APlatform BPlatform C
Initial Consult$49$79$0
Monthly Follow-up$29Included$49
Prescription SpeedSame day24-48 hoursSame day
Lab MonitoringRequiredOptionalRequired

I settled on the one that required labs — it shows they care about safety, not just prescribing volume.

Last edited: Nov 11, 2024 at 7:02 PM
32 2Dr.ObesityMed, HealthEcon_DC, PedsEndoPhilly and 29 others
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lucas_SP_BR
Member
456
1,890
Jun 2024
São Paulo, BR
Nov 11, 2024 at 5:09 PM#4
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…

Adding a me-too, because a thread of one person's experience is not much use. Posting only so the count is not one.

Last edited: Nov 11, 2024 at 7:09 PM
31 1KarenAZ_mom, zoe_NC, Dr.ObesityLA and 28 others
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Dr.KarenChen
VIP Member
4,210
24,567
Nov 2023
San Francisco, CA
Nov 11, 2024 at 5:42 PM#5

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.

30 0sarah_nash92, FitDadDave, RunnerRach and 27 others
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