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Success rate of filing a grievance against Anthem claim?

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Admin
(@admin)
Member Admin
Joined: 2 years ago
Posts: 1365
Topic starter   [#40876]

Records problem. The summary they hold about me is wrong by three items.

Function beats pain scores in these conversations. “I cannot sit for twenty minutes” lands.

Portal exports often carry the numbers and not the notes, and the notes are where the reasoning is.

Reconcile the medication list out loud, in the room. Silent reconciliation does not happen.

Happy to be told the process is simpler than I think.



   
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shore_link
(@shore_link)
New Member
Joined: 5 years ago
Posts: 4
 

Changing prescriber does not reset anything, and people discover that the hard way.



   
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JuliaS
(@julias)
Illustrious Member
Joined: 1 year ago
Posts: 7019
 

How do you tell the difference between the drug working and just a good week?



   
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wold7734
(@wold7734)
Active Member
Joined: 6 years ago
Posts: 6
 

Ten percent cuts. Slower is faster. Tolerance was my main issue with a formulary change too.



   
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TundraView
(@tundraview)
Active Member
Joined: 1 year ago
Posts: 5
 

Worth asking what specifically was measured. Pain scores move with mood and function does not.



   
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larchdeck71
(@larchdeck71)
Active Member
Joined: 4 years ago
Posts: 7
 

Worth asking what specifically was measured. Pain scores move with mood and function does not.



   
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Blackbird123
(@blackbird123)
Famed Member
Joined: 2 years ago
Posts: 2179
 

Fifteen years of this and the function column is the only one that changed anything for me. Also, one page of history, printed, handed over at the start. It changes the appointment.



   
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kite2490
(@kite2490)
Active Member
Joined: 2 years ago
Posts: 5
 

How do you tell the difference between the drug working and just a good week?



   
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skyharbor
(@skyharbor)
Active Member
Joined: 2 years ago
Posts: 8
 

Bring a list. Embarrassment makes everyone forget things, including you.



   
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haze9421
(@haze9421)
New Member
Joined: 1 year ago
Posts: 4
 

The pain score conversation is thirty seconds of my life I will never get back, every time.



   
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frostcove30
(@frostcove30)
Active Member
Joined: 2 years ago
Posts: 6
 

Interdose restlessness is distinct from the original symptom and worth naming separately.



   
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FlintEdge
(@flintedge)
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Joined: 3 years ago
Posts: 5
 

Same here.



   
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Alex
 Alex
(@alex)
Noble Member
Joined: 2 years ago
Posts: 1841
 

Reference ranges differ between labs, so comparing two reports is close to meaningless.



   
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dunesky
(@dunesky)
Active Member
Joined: 6 years ago
Posts: 8
 

Half of what people describe as tolerance is a change in the underlying condition, and the two need different answers.



   
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wrenlinden18
(@wrenlinden18)
Active Member
Joined: 5 months ago
Posts: 8
 

Enteric coatings should not be crushed. The pellets are the delivery mechanism.



   
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