I’m a doctor. I’ve been trying to get Ozempic approved for all my patients, but I keep getting denial after denial on the prior auths. It’s always for the same reason—the patient doesn’t have diabetes. Well… I accidentally stumbled onto a way around that…
See, the A1C lab test is the standard for diagnosing diabetes. An A1C over 6.5 means you have it. I had a patient who consistently hit 6.4 on her A1C… three times in a row. I suggested she try a GTT since it’s more sensitive. Boom: now she’s diabetic.
Then it clicked. With a Glucose Tolerance Test (GTT), you drink 100g of sugar and check back two hours later to see if your blood glucose is elevated. If it is… you’re diabetic. See where I’m going with this? Nobody actually monitors what you’re doing during those two hours; they just ‘ask’ that you fast. I explain this protocol to patients all the time. Wink wink, I really hope you aren’t diabetic. Oh no, you’re diabetic and your Ozempic is covered… I’m so incredibly sorry. /s
Please keep this little secret between us friends.