Topic

Blue Cross Blue Shield (BCBS Association)

A collection of 1126 issues

Work With Your Doctor to Get Filsuvez (birch triterpenes topical gel) Approved by Blue Cross Blue Shield in Florida: Complete Provider Collaboration Guide

Quick Answer: Getting Filsuvez Approved in Florida Filsuvez requires prior authorization from Florida Blue Cross Blue Shield. Your doctor must document confirmed dystrophic or junctional epidermolysis bullosa, target wound characteristics (partial-thickness, 21 days to 9 months old, 10-50 cm²), and failed standard wound care. Start today: Schedule an appointment to

Requirements Checklist to Get Zokinvy (lonafarnib) Covered by Blue Cross Blue Shield in New Jersey: Complete Prior Authorization Guide

Answer Box: Fast Track to Zokinvy Coverage To get Zokinvy (lonafarnib) covered by Blue Cross Blue Shield in New Jersey, you need: (1) confirmed HGPS or processing-deficient progeroid laminopathy diagnosis with genetic testing, (2) age ≥12 months with BSA ≥0.39 m², (3) specialist involvement, and (4) prior authorization through

How to Get Filspari (sparsentan) Covered by Blue Cross Blue Shield in Virginia: Prior Authorization Guide, Appeals Process, and State Protections

Answer Box: Getting Filspari Covered by Blue Cross Blue Shield in Virginia To get Filspari (sparsentan) covered by Blue Cross Blue Shield in Virginia, you need: (1) confirmed IgA nephropathy diagnosis with UPCR ≥1.5 g/g, (2) REMS program enrollment, and (3) prior authorization showing 90+ days of optimized

How to Get Zolgensma Covered by Blue Cross Blue Shield in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Zolgensma Covered by Blue Cross Blue Shield in New York Yes, Blue Cross Blue Shield plans in New York do cover Zolgensma for eligible children with spinal muscular atrophy (SMA). The fastest path to approval requires three key steps: 1) Confirm genetic testing shows bi-allelic SMN1 mutation

Getting Translarna (Ataluren) Covered by Blue Cross Blue Shield in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Started with Translarna Coverage Blue Cross Blue Shield plans in New York typically require prior authorization for Translarna (ataluren) and often list it as non-formulary due to its regulatory status. Success depends on having complete genetic documentation (nonsense mutation DMD), ambulatory status confirmation, and specialist prescriber involvement.

Getting Zanzalintinib (XL092) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Appeals Guide with Forms and External Review

Answer Box: Getting Zanzalintinib (XL092) Covered by Blue Cross Blue Shield in Pennsylvania Zanzalintinib (XL092) is an investigational multi-target TKI from Exelixis with no FDA approval, making Blue Cross Blue Shield coverage challenging but not impossible. Fastest path: Submit a medical necessity appeal through your Blue Cross Blue Shield plan&

How to Get Abecma (idecabtagene vicleucel) Covered by Blue Cross Blue Shield in Ohio: Complete Appeals Guide with State Protections

Answer Box: Fastest Path to Abecma Coverage in Ohio Blue Cross Blue Shield (primarily Anthem) in Ohio covers Abecma (idecabtagene vicleucel) under the medical benefit with prior authorization for relapsed/refractory multiple myeloma. Your fastest path: 1) Confirm you meet FDA criteria (≥2 prior lines including IMiD, proteasome inhibitor, and

How to Get iLink® Corneal Cross-Linking Covered by Blue Cross Blue Shield in New York: Prior Authorization Forms, Appeals Process, and Success Strategies

Quick Answer: Getting iLink® Covered by BCBS in New York Blue Cross Blue Shield plans in New York generally cover FDA-approved epithelium-off iLink® corneal cross-linking for progressive keratoconus when medical necessity criteria are met. Submit prior authorization through Availity (most plans) with documented progression evidence. If denied, New York'

Work With Your Doctor to Get Jynarque (tolvaptan) Approved by Blue Cross Blue Shield in Ohio: Complete Guide

Quick Answer: Getting Jynarque Covered in Ohio Blue Cross Blue Shield Ohio requires prior authorization for Jynarque (tolvaptan) based on documented rapidly progressive ADPKD. You'll need: Mayo imaging class 1C-1E OR eGFR decline ≥3-5 mL/min/1.73m²/year, normal liver tests, and REMS enrollment. Start by gathering

The Requirements Checklist to Get Ferriprox (deferiprone) Covered by Blue Cross Blue Shield in North Carolina

Answer Box: Getting Ferriprox Covered by Blue Cross Blue Shield in North Carolina Who qualifies: Patients with transfusional iron overload from thalassemia, sickle cell disease, or other anemias who need deferiprone (Ferriprox) therapy. Fastest path to approval: 1) Verify your Blue Cross NC plan type and formulary status, 2) Submit