Access Fund · Access Fund · your seat
Reading room, blind.
How a patient on the committee would read a request blind: no name, and no request number.
Access Fund · Access Fund · your seat
Reading room, blind.
A patient sitting on the fund committee declares no conflict, then reads a request blind: category, payee, amount, the paper, one sentence — no name, no request number until decided.
I do not know who asked, and the payee is not my clinician, my pharmacy or my employer. If either is false the read passes to an alternate.
A request, sealed
Category
—Payee
—Amount on the invoice
—The paper
—Their sentence
—
The category, the payee, the amount, the invoice or denial, and one optional sentence. Never the name. Never the record. Not even the request number, until the decision is in.
Eligibility · arithmetic, already run
- Inside the four categoriesnot run
- Under the cap, with the date it comes backnot run
- No award to this payee for this thing inside 90 daysnot run
- The payee takes a direct paymentnot run
- The denial was appealed, or the reason given — a fact, never a groundnot run
What you are deciding
- Award, whole or partialChoosedesigned
- Ask one question — the person answers onceChoosedesigned
- Decline on one of four grounds, with the sentence written outChoosedesigned
The four grounds, and no fifth
- Outside the four categories
- A supplement, a second first visit, a test that was covered, travel.
- Over the cap
- Say the arithmetic: the total it would reach, against the cap, and the date it comes back.
- Payee will not take a direct payment
- The fund never pays a person. Say what the payee said.
- Duplicate inside 90 days
- Same payee, same thing, same record. Name the earlier award’s date.
Each read is due 72 hours after assignment; a reminder goes at 48. The request is still promised a decision in seven days.
Load across seats · this week
Requests are assigned to the three least-loaded readers who did not read the person’s last request. The bars would show it; nothing has been assigned.