Topic

Darzalex / Darzalex Faspro (daratumumab)

A collection of 30 issues

How to Get Darzalex (Daratumumab) Covered by Aetna in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Darzalex Covered by Aetna in Texas Aetna requires prior authorization for Darzalex (daratumumab) for multiple myeloma and AL amyloidosis. Key steps: 1) Ensure FDA-approved indication with proper line of therapy documentation, 2) Submit precertification request via Aetna provider portal with clinical notes and prior treatment records, 3)

How Long Does It Take to Get Darzalex Approved by Humana in New Jersey? Complete Timeline & Appeal Guide

Answer Box: Getting Darzalex Approved by Humana in New Jersey Timeline: 1-30 days for initial approval, up to 65 days if appeals are needed. Humana requires prior authorization for both Darzalex (IV) and Darzalex Faspro (subcutaneous) in New Jersey. The fastest path: have your oncologist submit a complete PA request

How to Get Darzalex Covered by Aetna in Florida: Prior Authorization Forms, Step Therapy, and Appeal Process

Answer Box: Getting Darzalex Covered by Aetna in Florida Aetna requires prior authorization for Darzalex/Darzalex Faspro and enforces step therapy (typically requiring bortezomib first). To get approved: 1) Have your oncologist submit the complete PA form with clinical justification for bypassing step therapy, 2) Include documentation of prior treatments

How to Get Darzalex Covered by Blue Cross Blue Shield in Washington: Complete Guide with Appeals Process

Answer Box: Getting Darzalex Covered by Blue Cross Blue Shield in Washington Fast Track to Approval: Blue Cross Blue Shield plans in Washington require prior authorization for Darzalex (daratumumab), typically approving coverage for multiple myeloma patients who meet specific combination therapy requirements and have documented prior treatment history. Your first

Myths vs. Facts: Getting Darzalex/Darzalex Faspro Covered by Blue Cross Blue Shield in Texas

Quick Answer: Getting Darzalex/Darzalex Faspro Covered in Texas Blue Cross Blue Shield of Texas requires prior authorization for Darzalex (daratumumab) with specific documentation. Coverage depends on your multiple myeloma diagnosis, prior therapy history, and combination partners. Most denials stem from incomplete documentation or off-pathway use. First step: Have your

How to Get Darzalex Covered by Cigna in New York: Appeal Templates, Timelines & Prior Authorization Guide

Answer Box: Getting Darzalex Covered by Cigna in New York If Cigna denies Darzalex (daratumumab) coverage, you can appeal within 180 days. Most denials stem from insufficient prior therapy documentation or missing age verification (≥18 required). Quick action steps: 1) Call Cigna at 1-800-882-4462 for clarification, 2) Gather complete treatment

Coding That Helps Get Darzalex/Darzalex Faspro (Daratumumab) Approved by Humana in Michigan: ICD-10, J-Codes & Appeal Guide

Answer Box: Getting Darzalex/Darzalex Faspro Covered by Humana in Michigan Humana requires prior authorization for Darzalex (daratumumab) in 2024. The fastest path to approval: ensure proper ICD-10 coding (C90.00-C90.02 for multiple myeloma, E85.4/E85.9 for AL amyloidosis), use correct HCPCS code J9144 for Faspro billing,

How to Get Darzalex Covered by Blue Cross Blue Shield in California: Appeals Guide & Medical Necessity Templates

Quick Answer: Getting Darzalex Approved by Blue Cross Blue Shield in California Blue Cross Blue Shield California requires prior authorization for Darzalex (daratumumab) in 2024. To get coverage: (1) Your oncologist submits a prior authorization request with complete documentation of your multiple myeloma diagnosis and prior treatments, (2) If denied,

How Long Does It Take to Get Darzalex Approved by Humana in Florida? Complete Timeline & Fast-Track Guide

Answer Box: Fastest Path to Darzalex Approval Humana requires prior authorization for Darzalex/Darzalex Faspro in Florida, typically taking 14 days for standard requests or 72 hours for expedited cases. The fastest approval path involves your oncologist submitting complete documentation upfront—including diagnosis codes, treatment history, and clinical rationale—through

How to Get Darzalex Covered by Humana in New York: Step Therapy Laws, Appeals Process, and Prior Authorization Guide

Answer Box: Getting Darzalex Covered by Humana in New York Darzalex (daratumumab) requires prior authorization from Humana Medicare Advantage plans in New York. If denied, you can appeal internally and request external review through the New York Department of Financial Services (DFS) within four months. New York's step