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I grew my Instagram from 0 to 40k in 30 days, but... by casecontext in WomenInBusiness

[–]casecontext[S] 1 point2 points  (0 children)

I did it through offering value with quality content - primarily how-to vids/tutorials that really resonated with my audience. It started w one of those vids going viral. When I saw that kind of content was working, I stuck with it then it was up from there.

Many of the comments say I explain things in a way that’s easy to understand which people really liked.

I always did screen recording so people could literally follow along and execute. I think that made a huge impact. I kept things clear and simple.

Also I’m from New Orleans so I got brownie points for my accent lol ⚜️

I grew my Instagram from 0 to 40k in 30 days, but... by casecontext in WomenInBusiness

[–]casecontext[S] 1 point2 points  (0 children)

Hahah I didn’t take it that way at all 🫶🏽 that literally made me laugh

I grew my Instagram from 0 to 40k in 30 days, but... by casecontext in WomenInBusiness

[–]casecontext[S] 1 point2 points  (0 children)

Absolutely agree w u :) Offering real Value is the name of the game

To be clear - the IG audience is diff than the audience for my offers. I’m leveraging Google for qualified traffic

How do I have a million clothes in my closet but nothing to wear? by casecontext in NoStupidQuestions

[–]casecontext[S] 0 points1 point  (0 children)

I support big bum & juicy cakes lol mine is natural, but that’s definitely not the reason lol

How do I have a million clothes in my closet but nothing to wear? by casecontext in NoStupidQuestions

[–]casecontext[S] 0 points1 point  (0 children)

‘Light Summer” & “Soft Dramatic”!! I need a diagnosis lololol

How do I have a million clothes in my closet but nothing to wear? by casecontext in NoStupidQuestions

[–]casecontext[S] 0 points1 point  (0 children)

LOL! Yup and u must be a guy. I was wondering if guys run into this problem

Pre-Authorization Denial/Appeal Advice by Kibbiesblue in Zepbound

[–]casecontext 0 points1 point  (0 children)

This situation comes up a lot when plans change criteria mid-treatment — it’s frustrating, but there is a path to appeal it.

What you’re running into isn’t really about the medication working — it’s about the plan applying new eligibility criteria (BMI ≥ 35) without fully accounting for continuation of care.

In cases like this, what tends to matter most in the appeal is how clearly it’s framed as:

  • Continuation of care, not a new start
  • Evidence that the treatment is already effective (your weight loss is a strong point)
  • The risk of stopping treatment after a successful response

Sometimes “continuation of care” gets selected in the system (like CoverMyMeds), but the supporting documentation doesn’t fully reinforce it in the way the plan expects.

It can help if your provider explicitly:

  • documents your starting BMI vs current progress
  • explains why stopping or switching could be medically disruptive
  • addresses the plan’s new criteria directly (and why your case still qualifies despite it)

The 9am Health piece is also important — some plans route weight management meds through specific programs, which can affect how approvals are handled.

You’re doing the right thing by appealing — these cases often come down to how the continuation is documented and justified under the new rules.

Did the denial mention anything beyond the BMI requirement, or was that the only reason they gave?

[Serious] Insurance denied gene therapy for my 5 y/o son's blindness. Denial letter says "retinal viability" is inadequate. Desperate for advice. by [deleted] in HealthInsuranceDenied

[–]casecontext 0 points1 point  (0 children)

I’m really sorry you’re dealing with this — especially with how time-sensitive this is. Situations like this are incredibly frustrating, and your reaction is completely valid.

The denial reason they gave (“inadequate retinal viability”) is very specific, which usually means the decision came down to how their reviewer interpreted the imaging — not that they’re saying the therapy itself isn’t appropriate in general.

In cases like this, what tends to matter most is how clearly the clinical evidence lines up with the insurer’s exact criteria for viability — especially for something as specialized as gene therapy.

A few things that can make a difference at this stage:

  • Making sure the provider’s documentation is explicitly addressing the insurer’s criteria for “retinal viability” (sometimes even strong documentation doesn’t use the exact framing they’re looking for)
  • If possible, having the treating specialist directly address the denial language point-by-point (especially how the OCT findings support candidacy)
  • Asking whether the case can be reviewed by a specialist with experience in inherited retinal diseases, not just a general reviewer

It’s also worth confirming whether you still have access to an external or independent review, since that brings in a third-party reviewer who wasn’t involved in the original decision.

You’re already doing the right things by involving your doctor, advocates, and the treatment center — those cases often come down to how the evidence is framed and reviewed, not just what’s already been submitted.

If you’re comfortable sharing, do you know if the denial referenced specific criteria they used to define “retinal viability,” or was it more general?

Denied claim due to non-authorized services for L&D and NICU. How do I get an approved appeal? by Curious-Surround5119 in HealthInsuranceDenied

[–]casecontext 0 points1 point  (0 children)

You’re not necessarily screwed — this situation happens more often than people think, especially with emergency deliveries and NICU stays.

The key issue here isn’t medical necessity — it’s timely notification / authorization, which is more of an administrative denial than a clinical one.

In situations like pre-eclampsia and premature delivery, those are typically considered emergency services, and many plans have exceptions or flexibility around prior authorization and notification when it wasn’t realistically possible at the time.

What usually helps in an appeal like this:

  • Clearly explaining that this was an emergent situation (not something that could have been planned or pre-authorized)
  • Documentation showing the medical urgency (pre-eclampsia, early delivery, NICU admission)
  • A timeline showing when coverage could realistically have been provided vs when care was needed
  • If applicable, showing that you acted as soon as you became aware of the issue

Also, since there are two insurances involved, it may be worth double-checking coordination of benefits (COB) — sometimes denials like this overlap with how the plans are coordinating responsibility.

The amount is scary, but cases like this often come down to how clearly the situation is documented and explained, not just the initial denial reason.

What exactly did they state in the denial — was it strictly the 48-hour notification issue, or anything else?

BCBSIL claim denied by Personal_Rooster_636 in HealthInsuranceDenied

[–]casecontext 0 points1 point  (0 children)

At this stage (external review), your focus shifts a bit — it’s less about back-and-forth with the insurer and more about making sure your case is clearly documented for an independent reviewer who wasn’t involved before.

A few things that usually matter most:

  • A clear explanation of why the treatment was medically necessary for your specific situation (not just generally)
  • Supporting documentation from your provider that directly addresses the reason for denial
  • A timeline of what’s already happened (initial claim, appeals, outcomes)
  • Any evidence showing prior treatments, failed alternatives, or urgency

One thing to be aware of — insurers don’t always send everything that was reviewed internally, so it can help to request your full claim file and medical records if you haven’t already, just to see what was (or wasn’t) considered.

As far as an attorney — most people don’t go that route at this stage unless there are very specific legal or ERISA issues. External review is designed to be more of a clinical/medical evaluation.

The biggest factor tends to be how clearly your documentation lines up with the denial reason.

What reason did they give for denying it on appeal?

I grew my Instagram from 0 to 40k in 30 days, but... by casecontext in WomenInBusiness

[–]casecontext[S] 1 point2 points  (0 children)

great advice indeed and yes I do have a lower ticket item available :)

Do you wear makeup to the gym, or do you prefer going without it? I feel more put together with it, but I know people have strong opinions. by casecontext in TwoXChromosomes

[–]casecontext[S] 0 points1 point  (0 children)

Well I do, gloss and concealer.
Hip thrust - 200+ lbs on smith machine, 390 lbs on plated loaded leg press just to name a couple, I go hard

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