Topic

Blue Cross Blue Shield (BCBS Association)

A collection of 1063 issues

Renewing Xywav (Ca/Mg/K/Na oxybates) Approval with Blue Cross Blue Shield in California: Annual Requirements, Timeline & Bridge Options

Answer Box: Xywav Renewal with Blue Cross Blue Shield California Blue Shield of California requires annual reauthorization for Xywav with documentation of continued clinical benefit, appropriate dosing, and ongoing safety monitoring. Submit renewal requests 30-60 days before expiration through AuthAccel or CoverMyMeds. Required documentation includes recent progress notes showing reduced
6 min read

How to Get Abecma (idecabtagene vicleucel) Covered by Blue Cross Blue Shield of Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Fastest Path to Abecma Coverage Blue Cross Blue Shield of Texas requires prior authorization for Abecma (idecabtagene vicleucel) for relapsed/refractory multiple myeloma after ≥2 prior therapies including an IMiD, proteasome inhibitor, and anti-CD38 antibody. Submit PA via provider portal with complete treatment history, organ function labs, and
5 min read

How to Get Keppra (Levetiracetam) Covered by Blue Cross Blue Shield in New Jersey: Prior Authorization Guide and Appeal Strategies

Answer Box: Quick Path to Coverage To get Keppra (levetiracetam) covered by Blue Cross Blue Shield in New Jersey: Most plans prefer generic levetiracetam (usually Tier 1-2, no PA required). For brand Keppra, expect prior authorization requiring documented failure/intolerance to generic plus clinical justification. Submit PA via provider portal
6 min read

How to Get Crysvita (burosumab) Covered by Anthem Blue Cross Blue Shield Virginia: Prior Authorization, Appeals & External Review Guide

Answer Box: Getting Crysvita Covered by Anthem BCBS Virginia Anthem Blue Cross Blue Shield Virginia requires prior authorization for Crysvita (burosumab) with strict clinical criteria. To get approval: (1) Your endocrinologist submits genetic XLH confirmation plus low serum phosphorus labs via Anthem's clinical criteria portal, (2) Document failed/
7 min read

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

Answer Box: Getting Xembify Approved in New York Xembify (immune globulin subcutaneous) requires prior authorization from Blue Cross Blue Shield in New York for primary immunodeficiency coverage. Submit your PA request through Availity Essentials Authorization app with diagnosis confirmation, lab evidence (low IgG levels), infection history, and weight-based dosing rationale.
7 min read

Renewing Approval for Kalydeco (Ivacaftor) with Blue Cross Blue Shield in California: What to Prepare & When

Answer Box: Kalydeco Renewal Essentials Renew your Kalydeco (ivacaftor) authorization with Blue Cross Blue Shield of California 2-4 weeks before expiration. Submit via AuthAccel portal with updated clinic notes, liver function tests, FEV₁ data, and adherence documentation. Most renewals require proof of ongoing benefit (stable/improved lung function, reduced exacerbations)
6 min read