Topic

Cigna

A collection of 1060 issues

How to Get Bylvay (odevixibat) Covered by Cigna in North Carolina: Forms, Appeals, and State Protections

Answer Box: Getting Bylvay (odevixibat) Covered by Cigna in North Carolina Cigna requires prior authorization for Bylvay (odevixibat) with strict criteria: confirmed PFIC (≥3 months) or Alagille syndrome (≥12 months) diagnosis, failed trials of ursodiol and pruritus medications, and specialist prescription. First step: Have your hepatologist submit PA through Cigna&

Coding That Helps Get Tegsedi (inotersen) Approved by Cigna in Florida: ICD-10, HCPCS/J-Code, and NDC Guide

Answer Box: Getting Tegsedi (inotersen) Coded Correctly for Cigna Coverage in Florida Fastest path to approval: Use ICD-10 code E85.1 (neuropathic heredofamilial amyloidosis), HCPCS J3490 (unclassified drugs) with NDC 72126-0007-02, and submit via Cigna's electronic PA system through Express Scripts/Accredo. Tegsedi requires prior authorization under the

How to Get Hetlioz LQ (tasimelteon oral suspension) Covered by Cigna in Illinois: Complete Prior Authorization and Appeals Guide

Answer Box: Cigna requires prior authorization for Hetlioz LQ (tasimelteon oral suspension) for Smith-Magenis syndrome in children 3-15 years old. Submit PA through Express Scripts/Accredo with genetic SMS confirmation, sleep specialist evaluation, and documented failures of ramelteon plus one alternative. Appeals follow Illinois's strong patient protection laws

A Realistic Alecensa (Alectinib) Approval Scenario with Cigna in Pennsylvania (From Request to Yes)

Answer Box: Getting Alecensa (Alectinib) Approved by Cigna in Pennsylvania Quick Path to Approval: Cigna requires prior authorization for Alecensa (alectinib) in ALK-positive NSCLC. Submit documented ALK-positive test results, pathology confirming NSCLC, and prescriber attestation via Cigna's PA portal. Most approvals occur within 72 hours for metastatic cases;

How to Get Prolastin-C (Alpha1-Proteinase Inhibitor) Covered by Cigna in Michigan: Complete PA Guide and Appeals Process

Answer Box: Getting Prolastin-C Covered by Cigna in Michigan Cigna requires prior authorization for Prolastin-C (alpha1-proteinase inhibitor) with step therapy preference over Zemaira. Key requirements: severe AAT deficiency (genotype Pi*ZZ or equivalent), serum AAT <80 mg/dL, emphysema documentation, and non-smoker status. First step today: Have your pulmonologist

Renewing Rystiggo (rozanolixizumab-noli) Approval with Cigna in Georgia: Timeline, Documentation & Appeal Rights

Answer Box: Renewing Rystiggo with Cigna in Georgia Cigna typically approves Rystiggo (rozanolixizumab-noli) for 3-6 months initially, then 6-12 months for renewals. Submit renewal requests 2-4 weeks before expiration with updated MG-ADL scores showing ≥2-point improvement from baseline, current neurology notes, and documentation of continued benefit. If denied, you have

How to Get Tysabri (Natalizumab) Covered by Cigna in Georgia: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tysabri Covered by Cigna in Georgia Cigna requires prior authorization for Tysabri (natalizumab) in Georgia with strict medical necessity criteria including TOUCH program enrollment, failed first-line DMTs, and comprehensive safety monitoring. Start by having your neurologist submit a PA request with documented step therapy failures, JCV antibody

How to Get Photrexa Covered by Cigna in Illinois: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Photrexa Covered by Cigna in Illinois Cigna covers Photrexa (riboflavin ophthalmic solution) for progressive keratoconus with prior authorization. Submit PA through your ophthalmologist with documented progression (≥1.0 D Kmax increase over 12-24 months), serial topography, and medical necessity letter. If denied, file internal appeal within 180

How to Get Filsuvez (Birch Triterpenes Topical Gel) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Filsuvez Covered by Cigna in Ohio Cigna requires prior authorization for Filsuvez (birch triterpenes topical gel) for epidermolysis bullosa patients aged 6+ months with dystrophic or junctional EB subtypes. Submit PA through Express Scripts/Accredo with genetic testing, wound photos, and medical necessity letter. If denied, file

Work With Your Doctor to Get Jynarque (Tolvaptan) Approved by Cigna in California: PA Requirements and Appeals Guide

Answer Box: Getting Jynarque (Tolvaptan) Approved by Cigna in California Cigna requires prior authorization for Jynarque (tolvaptan) via Express Scripts for adults ≥18 with rapidly progressing ADPKD. Your nephrologist must document eGFR decline ≥3.0 mL/min/1.73m²/year OR Mayo Classification 1C-1E, plus baseline eGFR ≥25, REMS enrollment,