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home:mp:insurance [01.08.2013] – [Appealing a denial for Benicar] sallieq | home:mp:insurance [09.14.2022] (current) – external edit 127.0.0.1 | ||
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===== Doctors have a right to exercise their judgment | ===== Doctors have a right to exercise their judgment | ||
- | According to a [[http:// | + | According to a [[https:// |
It is the doctor who has the license to practice medicine – not the insurance company! With the consent of the patient, it is the doctor' | It is the doctor who has the license to practice medicine – not the insurance company! With the consent of the patient, it is the doctor' | ||
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* **Experimental** – Some insurers consciously do not cover medications considered experimental, | * **Experimental** – Some insurers consciously do not cover medications considered experimental, | ||
* **Off-label use** – In the context of the MP, referring Benicar use as off-label is ill-advised – even though off-label use of medications is [[home: | * **Off-label use** – In the context of the MP, referring Benicar use as off-label is ill-advised – even though off-label use of medications is [[home: | ||
- | * **If accurate, a diagnosis of hypertension is helpful** – If a patient fits the criteria for diagnosis of hypertension, | + | * **If accurate, a diagnosis of hypertension is helpful** – If a patient fits the criteria for diagnosis of hypertension, |
< | < | ||
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The label: | The label: | ||
- | http:// | + | https:// |
- | http:// | + | https:// |
--> | --> | ||
</ | </ | ||
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- The initial problem may be with the pharmacy, which sometimes has upper limits on the dose and frequency of certain medications. Sometimes this will need to be overridden by one's insurance company. | - The initial problem may be with the pharmacy, which sometimes has upper limits on the dose and frequency of certain medications. Sometimes this will need to be overridden by one's insurance company. | ||
- Other times all that is needed to override an initial denial is a phone call from the doctor' | - Other times all that is needed to override an initial denial is a phone call from the doctor' | ||
- | - If a doctor override is not sufficient, accept the standard amount of pills until the insurance company approves the increased dosage. | + | - If a doctor override is not sufficient, accept the standard amount of pills until the insurance company approves the increased dosage. |
- Contact the insurance company and ask if their doctors produced a letter of medical necessity would allow for full coverage of Benicar (see below). | - Contact the insurance company and ask if their doctors produced a letter of medical necessity would allow for full coverage of Benicar (see below). | ||
- Ask for an explanation of the decision and the specific rationale why the claim was denied. The reason given will dictate the peer-reviewed papers and other materials presented to the insurance company. | - Ask for an explanation of the decision and the specific rationale why the claim was denied. The reason given will dictate the peer-reviewed papers and other materials presented to the insurance company. | ||
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- | * {{pubmed> | + | * {{pmid> |
- | * {{pubmed> | + | * {{pmid> |
- | Efficacy of Benicar has been described in various conditions by a [[home: | + | Efficacy of Benicar has been described in various conditions by a [[home: |
==== Letters to present to an insurance company ==== | ==== Letters to present to an insurance company ==== | ||
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===== Read more ===== | ===== Read more ===== | ||
- | * [[http:// | + | * [[https:// |
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- | {{tag> | + | {{tag>MP Starting_the_Marshall_Protocol}} |
+ | < | ||
===== Notes and comments ===== | ===== Notes and comments ===== | ||
+ | * CureMyTh1.org references removed during transition to closing that site. --- //Joyful 01.04.2014// | ||
* Legacy content | * Legacy content | ||
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |
- | * http:// | + | * https:// |