Topic

Cigna

A collection of 1139 issues

How to Get Lutathera (lutetium Lu-177 dotatate) Approved by Cigna in Georgia: Timeline, Forms & Appeal Process

Answer Box: Getting Lutathera Covered by Cigna in Georgia Cigna typically approves Lutathera (lutetium Lu-177 dotatate) within 2 business days when complete documentation is submitted electronically through Accredo's prior authorization portal. Key requirements: confirmed somatostatin receptor-positive imaging, documented progression on somatostatin analogs, and nuclear medicine facility certification. If

How to Get Juxtapid (Lomitapide) Approved by Cigna in New Jersey: 2025 Rules, Appeals, and Step Therapy Overrides

Answer Box: Fast Track to Juxtapid Coverage Getting Juxtapid (lomitapide) approved by Cigna in New Jersey requires genetic/phenotypic HoFH documentation and step therapy compliance. New Jersey's 2025 laws mandate 72-hour decisions for standard requests (24 hours urgent). If denied, you have 180 days for internal appeals, then

How to Get Synagis (Palivizumab) Covered by Cigna in Florida: Provider Partnership Guide

Answer Box: Getting Synagis Covered by Cigna in Florida Synagis (palivizumab) requires prior authorization from Cigna for high-risk infants meeting specific criteria. The fastest path to approval: (1) Confirm your child meets AAP-approved risk factors (premature birth <29 weeks, congenital heart disease, chronic lung disease), (2) Have your pediatric

How to Get Xembify Covered by Cigna in Florida: Prior Authorization Forms, Appeals, and Approval Strategy

Answer Box: Getting Xembify Covered by Cigna in Florida Cigna requires prior authorization for Xembify (immune globulin, SC) in Florida. Your fastest path to approval: (1) Confirm your primary immunodeficiency diagnosis with documented low IgG levels and recurrent infections, (2) Submit the complete prior authorization form with clinical notes via

How to Get Vanflyta (Quizartinib) Covered by Cigna in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Vanflyta (Quizartinib) Covered by Cigna in Texas Vanflyta (quizartinib) requires prior authorization from Cigna and typically involves step therapy requirements. Most approvals take 7-14 days with complete documentation. Fastest path: 1) Confirm FLT3-ITD positive AML diagnosis with genetic testing results, 2) Document failure/intolerance of preferred FLT3

How to Get Bavencio (avelumab) Covered by Cigna in Michigan: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Bavencio (avelumab) Covered by Cigna in Michigan Bavencio (avelumab) requires prior authorization from Cigna and is placed on Tier 5 (specialty) with high cost-sharing. To get coverage in Michigan: 1. Submit Cigna's prior authorization form with diagnosis confirmation (metastatic Merkel cell carcinoma or maintenance urothelial

Getting Rinvoq (upadacitinib) Covered by Cigna in North Carolina: Complete Guide with Appeal Forms and State Protections

Answer Box: Getting Rinvoq (upadacitinib) Covered by Cigna in North Carolina Eligibility: Cigna requires prior authorization for Rinvoq with step therapy requirements (failed TNF inhibitors or DMARDs). Fastest path: Submit complete clinical documentation showing prior therapy failures through Cigna's provider portal or formulary exception process. First step today:

Getting Kalydeco (Ivacaftor) Covered by Cigna in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Kalydeco (Ivacaftor) Covered by Cigna in Michigan Eligibility: Patients with cystic fibrosis and documented FDA-approved CFTR mutations responsive to ivacaftor can get Kalydeco covered by Cigna with proper documentation. Fastest Path: 1) Gather CFTR genotype test results and CF diagnosis documentation, 2) Have your CF specialist submit

How to Get Cerezyme (Imiglucerase) Covered by Cigna in Illinois: Complete Coding, Appeals, and Prior Authorization Guide

Answer Box: To get Cerezyme (imiglucerase) covered by Cigna in Illinois, you need proper coding (ICD-10: E75.22, HCPCS: J1786), specialist documentation of Type 1 Gaucher disease with enzyme deficiency, and prior authorization through Cigna's specialty drug process. If denied, Illinois law gives you strong appeal rights including

Work With Your Doctor to Get Emgality (galcanezumab-gnlm) Covered by Cigna in Pennsylvania: Appeals Guide

Answer Box: Getting Emgality Covered by Cigna in Pennsylvania Eligibility: Cigna requires prior authorization for Emgality (galcanezumab-gnlm) with step therapy requirements—typically failure of 2+ oral preventives from different classes. Fastest path: Work with your doctor to document migraine frequency (4+ days/month), prior treatment failures, and functional disability. Submit