Topic

Blue Cross Blue Shield (BCBS Association)

A collection of 1068 issues

Renewing Haegarda (C1-Esterase Inhibitor) Approval with Blue Cross Blue Shield in Washington: Timeline, Forms & Appeal Process

Answer Box: Renewing Haegarda with Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington require annual renewal for Haegarda (C1-esterase inhibitor) with documentation of continued HAE diagnosis and clinical benefit. Start your renewal 60-90 days before expiration by submitting updated attack logs, specialist notes showing reduced
6 min read

How Long Does It Take to Get Orladeyo (berotralstat) Approved by Blue Cross Blue Shield in Ohio? Complete Timeline & Appeal Guide

Answer Box: Getting Orladeyo Approved by Blue Cross Blue Shield in Ohio Timeline: 1-14 days for standard prior authorization, 24-72 hours for urgent cases. Blue Cross Blue Shield Ohio (primarily Anthem) requires prior authorization for Orladeyo (berotralstat) with specialist documentation of hereditary angioedema diagnosis, C1-INH testing, and often step therapy
6 min read

Do You Qualify for Nourianz (Istradefylline) Coverage by Blue Cross Blue Shield of Michigan? Complete Decision Tree & Appeals Guide

Quick Answer: Getting Nourianz Covered by BCBS Michigan You likely qualify for Nourianz (istradefylline) coverage if you're an adult with Parkinson's disease experiencing OFF episodes despite optimized levodopa/carbidopa therapy. BCBS Michigan typically requires prior authorization with documentation of failed alternative treatments. First step today: Check
6 min read

How to Get Breyanzi Covered by Blue Cross Blue Shield of Michigan: Prior Authorization Guide and Appeals Process

Answer Box: Getting Breyanzi Covered in Michigan Blue Cross Blue Shield of Michigan requires prior authorization for Breyanzi (lisocabtagene maraleucel) under their medical benefit, with coverage limited to FDA-approved indications after documented failure of prior therapies. Submit requests using the BCBSM Medication Authorization Request Form (fax to 1-877-325-5979), including cardiac
5 min read

How to Get Cimzia (Certolizumab Pegol) Covered by Blue Cross Blue Shield in Georgia: Complete PA Guide with Forms and Appeals

Answer Box: Getting Cimzia Covered by Blue Cross Blue Shield in Georgia Cimzia (certolizumab pegol) requires prior authorization from Blue Cross Blue Shield of Georgia (Anthem) for all commercial plans. To get coverage, you need documented failure of step-therapy requirements (typically other TNF inhibitors like Humira), proper diagnosis codes, and
6 min read

How to Get Krystexxa (Pegloticase) Covered by Blue Cross Blue Shield in Georgia: Prior Authorization, Appeals, and State Protections Guide

Answer Box: Getting Krystexxa Covered by Blue Cross Blue Shield in Georgia Fastest path to approval: Submit prior authorization through BCBS provider portal with complete documentation of failed xanthine oxidase inhibitor trials (allopurinol/febuxostat), G6PD test results, and rheumatology evaluation. Georgia's step therapy exception law (§33-24-59.25) requires
7 min read