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Prior Authorization for Fiasp

Question:

I am looking for a template letter for prior authorization to justify Fiasp. The response we got from insurance was that it does not improve glycemic outcomes relative to Humalog novolog. I need some sort of protest letter with citations. Please share if you have them.

Name: Joyce Lee, MD
Clinic: C.S Mott Children’s Hospital
Adult or Pediatric Population: Both
Date: 11/1/2023
T1DX-QI

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