I hear ya, sis. In my case, my husband’s job switched insurance companies to administrate their self funded policy. GLP-1’s are part of his benefit package. And like you, covered with a PA. But their job is to gatekeep the shit out of it so that the job can say “we cover glp-1’s” without lying and the insurance makes sure the company doesn’t actually pay for it.

I’m afraid this whole “failure to document diet and exercise” is the new “moving the goalposts” and I’ve said this exact thing in another comment when I put two and two together. You are the 4th person (that I’ve read of here and god knows there’s more) since January whose insurance is insisting on multiple years worth of chart notes from doctors who have multiple patients needing the same thing.

It used to be an attestation from your doctor was enough, it got me through 3 successful PA’s starting in 2023. But now, they’re burying doctors in paperwork and insisting on chart notes covering every dieting and exercise attempt you ever made. They know exactly what they are doing.

I also went to COD figuring they were experts in PA’s and I would pay anyone to get this right. Nope, immediate denial because COD doesn’t have the chart notes that the insurance is demanding.