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ForumsVendor ReviewsTelehealth provider comparison — need advice

Telehealth provider comparison — need advice

ingrid_STO Thu, May 30, 2024 at 12:20 PM 63 replies 3,076 viewsPage 1 of 13
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ingrid_STO
Member
345
1,456
Jul 2024
Stockholm, SE
May 30, 2024 at 12:20 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.

The narrow version of the question is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work.

Practical detail welcome, however dull — the duller the better.

16 11VendorMark, COA_Karl, MikeFit_NJ and 13 others
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FDA_TrackerJim
Senior Member
1,567
7,890
Feb 2024
Rockville, MD
May 30, 2024 at 12:26 PM#2
ingrid_STO 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 $278/month (eating less)
  • Restaurants: SAVED $188/month (fewer meals out)
  • Alcohol: SAVED $138/month (stopped drinking)
  • Life insurance: Premium REDUCED by $48/month (lower BMI)
  • Copays: SAVED $78/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.

15 10Admin, Dr.Martinez, mike_mod and 12 others
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DoseLogDan
Member
201
567
Feb 2025
Montana
May 30, 2024 at 12:32 PM#3
FDA_TrackerJim said:
Financial impact of cost and coverage weight loss beyond medication cost: Groceries: SAVED $278/month (eating less) Restaurants: SAVED $188/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$89$0
Monthly Follow-up$39Included$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.

14 9mel_PDX, Dr.AddMedPHL, newstart_MO and 11 others
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RickReta_CO
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312
1,234
Jan 2025
Colorado
May 30, 2024 at 12:38 PM#4
ingrid_STO 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…

Second this. I had assumed I was the exception until I read this.

13 8tommy_boulder, hyun_seoul, jim_asheville and 10 others
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Dr.NutriCornell
Senior Member
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Mar 2024
Ithaca, NY
May 30, 2024 at 1:08 PM#5

From the other side of the consultation, briefly.

ingrid_STO said:
...regarding the discontinuation data for cost and coverage...

I want to reframe the discontinuation narrative. We don't say "insulin fails because blood sugar rises when you stop it." We don't say "antihypertensives fail because BP goes up without them."

Why do we apply different logic to anti-obesity medications? The answer is stigma. We still, unconsciously, believe obesity is about willpower rather than biology. The discontinuation data actually PROVES it's a chronic biological condition requiring ongoing treatment.

This reframing isn't semantic — it has implications for insurance coverage, treatment duration, and patient expectations.

Last edited: May 30, 2024 at 3:08 PM
12 7pat_auckland, Dr.GastroMayo, JakeBK_lifts and 9 others
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