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Common problems include: Incomplete paperwork: missing fields, unsigned forms, or omitted chart attachments Weak evidence of medical necessity: the diagnosis is present, but the supporting history is thin Missing comorbidity documentation: the condition may be in the patient’s history but not clearly included in the submission No proof of prior lifestyle effort: many plans want evidence, not just a statement Step therapy gaps: if the plan requires trying another option first, that requirement has to be addressed directly Some patients also run into a coverage issue that has nothing to do with their health