Prolia (Denosumab)- Medicare advantage only (When policy is covered section)

Dear Writer,

How’re you doing? I really hope you have an experience with writing medical policies for insurance companies. If you do not have any experiences then I highly recommend you look up samples of medical policies written by insurance companies and I’ve provided a very good resources in my attached document titled “notes” This document contains two pages, page one is links of the various resources which I think will be helpful in getting you started. Then on the second page you will see a draft which was sent to me from another colleague so I need you expertise in writing me an improved and solid policy for those covered. Please please read more about what goes into that section before you get started. It’s going to require a lot of Medical and pharmacy knowledge. I am faithful that you will not let me down.

Right now I’ve been assigned to revised a medical policies for a particular insurance company. The medication which this medical policies is being revised for is the drug called Prolia. I’ve attached the medical policy draft and when you open it, you will be asked to put in a password so go ahead and type in “draft” for the password. Please do not include the quotes when you actually type in the password, i just included it so it can stand out. No cap letter just type it as it is. Once you put in the password you will see the complete draft of the medical policy for the drug Prolia. For this particular order, OUR ONLY FOCUS IS THE SECTION TITLED “WHEN POLICY IS COVERED” THAT IS THE SECTION I NEED YOUR HELP WITH. PLEASE DO NOT WORRY ABOUT THE OTHER SECTIONS, YOU CAN READ THEM FOR YOUR OWN UNDERSTANDING BUT FOR THE SAKE OF THIS ORDER WE AARE ONLY FOCUSING ON THAT SECTION.

https://www.anthem.com/ms/pharmacyinformation/Denosumab-Agents.pdf

I think the link above does a really great job at giving you great details in some of the criteria that are considered when trying to see if the insurance should cover prolia treatment for a particular individual given that they meet those criteria.

Please note the draft on page 2 of the document titled “notes” and also the draft found under the “When policy is covered” section of the document titled” Prolia(denosumab) is what we are trying to improve.

I hope this helps and Please please if you need any clarifications on any of these instructions then please please ask, do not hesitate to ask.

Looking forward to your work! Please please look at guidelines of treatments and do extensive research and make sure you cite all resources you have used.

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