Topic

Blue Cross Blue Shield (BCBS Association)

A collection of 1267 issues

How Long Does It Take to Get Cresemba (Isavuconazole) Approved by Blue Cross Blue Shield in Florida? Complete Timeline Guide

Answer Box: Getting Cresemba Approved in Florida Blue Cross Blue Shield of Florida typically requires prior authorization for Cresemba (isavuconazole) with 2-3 business days for electronic submissions and up to 14 calendar days for fax requests. The fastest path: have your infectious disease specialist submit complete documentation via electronic PA
5 min read

How to Get Xenpozyme (Olipudase Alfa-rpcp) Covered by Blue Cross Blue Shield in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Xenpozyme Covered in Texas Blue Cross Blue Shield of Texas (BCBSTX) typically requires prior authorization for Xenpozyme (olipudase alfa-rpcp) under the medical benefit using HCPCS code J0218. Most approvals require genetic confirmation of acid sphingomyelinase deficiency (ASMD), baseline organ assessments, and specialist oversight. First step today: verify
5 min read

The Complete Requirements Checklist to Get Gattex (teduglutide) Covered by Blue Cross Blue Shield in California

Answer Box: Fast Track to Gattex Coverage Blue Shield of California requires prior authorization for Gattex (teduglutide) for patients with parenteral-nutrition-dependent short bowel syndrome. Submit PA through the Provider Connection portal with SBS diagnosis confirmation, PN dependence documentation, and clinical evidence. If denied, file an internal appeal within plan timelines,
6 min read

How to Get Cometriq (cabozantinib) Covered by Blue Cross Blue Shield in New Jersey: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Cometriq Covered in New Jersey Cometriq (cabozantinib capsules) requires prior authorization from Blue Cross Blue Shield in New Jersey for metastatic medullary thyroid carcinoma. Your oncologist submits the PA electronically with pathology reports, imaging showing progression, and medical necessity documentation. If denied, you have 180 days to
6 min read

Blue Cross Blue Shield Ohio's Coverage Criteria for Exondys 51: What Counts as "Medically Necessary"?

Answer Box Blue Cross Blue Shield of Ohio (Anthem) requires prior authorization for Exondys 51 (eteplirsen) with specific medical necessity criteria: confirmed DMD with exon 51-amenable genetic mutation, stable corticosteroid therapy ≥6 months, meaningful motor function, and neurologist prescriber. Submit PA via Anthem provider portal with genetic test results, baseline
6 min read

Work With Your Doctor to Get Cresemba (Isavuconazole) Approved by Blue Cross Blue Shield in New Jersey: PA Forms, Appeals, and Medical Necessity Letters

Quick Answer: Getting Cresemba Approved by Blue Cross Blue Shield in New Jersey Eligibility: Cresemba requires prior authorization for invasive aspergillosis or mucormycosis with confirmed diagnosis and often ID specialist involvement. Fastest path: Have your infectious disease specialist submit a comprehensive medical necessity letter documenting failed voriconazole therapy or contraindications,
7 min read