Understand, I think I am seeing this, but I don't necessarily have a thesis on what is happening.
As a matter of course many people were refused when new therapies get approved.
But (jaded, cynical me) I sometimes think that insurance carriers operate a little like in "The Rainmaker" model, and just refuse a few times as a matter of course. When you have a "benefits manager", perhaps the application has the opportunity to get stalled, misdirected or refused even further.
As time goes by, doctors and their offices get better at navigating the hurdles. Some patients are being counseled on line in HCV forums to better navigate the system.
In the day and age of Obamacare, is it possible that people shop insurance companies, drop QRS and add XYZ in order to get certain coverage?
What if a carrier or benefits manager built into the system delays and refusals, and so the patient went to an alternate insurer?
I truly don't understand the system, but I have observed it a little from afar.
IF these people are getting approved for Harvoni after being refused 3 times, is it possible they are being refused by ESRX/ or for Viekira Pak?
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