Topic

Dojolvi (triheptanoin)

A collection of 21 issues

How to Get Dojolvi (Triheptanoin) Covered by Aetna in Michigan: Complete Prior Authorization and Appeals Guide 2025

Answer Box: Getting Dojolvi Covered by Aetna in Michigan Dojolvi (triheptanoin) is not on Aetna's formulary, requiring a formulary exception and prior authorization. You'll need genetic confirmation of LC-FAOD, specialist documentation, and proof you're not using other MCT products. If denied, Michigan gives you

How to Get Dojolvi (Triheptanoin) Covered by Blue Cross Blue Shield in Ohio: Complete PA Guide with Appeal Scripts

Answer Box: Getting Dojolvi Covered by Blue Cross Blue Shield in Ohio You can get Dojolvi (triheptanoin) covered by Blue Cross Blue Shield Ohio, but it requires molecular confirmation of LC-FAOD and specialist oversight. Start by gathering genetic test results proving your long-chain fatty acid oxidation disorder diagnosis, then have

How to Get Dojolvi (Triheptanoin) Covered by Cigna in New York: Complete PA Guide with Appeal Scripts

Answer Box: Getting Dojolvi Covered by Cigna in New York Eligibility: Patients with molecularly confirmed long-chain fatty acid oxidation disorders (LC-FAOD) can get Dojolvi (triheptanoin) covered by Cigna through prior authorization. Fastest path: Submit PA with genetic testing results, metabolic specialist prescription, and documentation that no other MCT products are

How to Get Dojolvi (Triheptanoin) Covered by Blue Cross Blue Shield in Illinois: Complete PA and Appeal Guide

Answer Box: Getting Dojolvi Covered by BCBS Illinois Blue Cross Blue Shield Illinois requires prior authorization for Dojolvi (triheptanoin) with molecular confirmation of LC-FAOD. The fastest path: (1) Gather genetic test results showing pathogenic variants in CPT2, ACADVL, HADHA, or HADHB genes, (2) Have a metabolic specialist complete the PA

How to Get Dojolvi (Triheptanoin) Covered by Humana in Georgia: Complete Coding and Appeal Guide

Answer Box: Getting Dojolvi (Triheptanoin) Covered by Humana in Georgia Dojolvi (triheptanoin) requires prior authorization from Humana Medicare Advantage, billed under NDC 69794-0050-50 with ICD-10 codes E71.310 or E71.318. Your prescriber must submit molecular genetic confirmation of long-chain fatty acid oxidation disorder (LC-FAOD) plus clinical documentation. If denied,

How to Get Dojolvi (Triheptanoin) Covered by UnitedHealthcare in Pennsylvania: Complete PA Guide & Appeal Scripts

Answer Box: Getting Dojolvi Covered by UnitedHealthcare in Pennsylvania Quick Path to Approval: UnitedHealthcare requires prior authorization for Dojolvi (triheptanoin) with molecular confirmation of long-chain fatty acid oxidation disorder (LCFAOD), prescription by a board-certified medical geneticist, and no concurrent MCT oil use. If denied, Pennsylvania's new external review

How to Get Dojolvi (Triheptanoin) Covered by UnitedHealthcare in Michigan: Complete PA Guide with Appeal Scripts

Answer Box: Getting Dojolvi Covered by UnitedHealthcare in Michigan Dojolvi (triheptanoin) requires prior authorization from UnitedHealthcare for long-chain fatty acid oxidation disorders (LC-FAOD). Key requirements: molecular genetic confirmation of LC-FAOD, prescription from a board-certified medical geneticist, no concurrent MCT products, and dosing ≤35% of daily calories. First step: Download the

How to Get Dojolvi (Triheptanoin) Covered by Aetna CVS Health in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Dojolvi Covered by Aetna CVS Health in Texas Dojolvi (triheptanoin) requires prior authorization from Aetna CVS Health and is not on the 2024 formulary, requiring a formulary exception. Essential requirements include genetic/biochemical LC-FAOD confirmation, specialist documentation, and proof that dietary management alone is inadequate. First step

How to Get Dojolvi (Triheptanoin) Covered by UnitedHealthcare in Ohio: Complete Resource Guide

Quick Answer: Getting Dojolvi Covered by UnitedHealthcare in Ohio To get Dojolvi (triheptanoin) approved by UnitedHealthcare in Ohio: Submit a prior authorization through the UHC Provider Portal or fax 866-940-7328 with genetic testing confirming LC-FAOD, prescription from a board-certified medical geneticist, and documentation that no MCT products are being used

How to Get Dojolvi (triheptanoin) Covered by Cigna in Virginia: Complete Appeals Guide

Answer Box: Getting Dojolvi (triheptanoin) Covered by Cigna in Virginia Cigna requires prior authorization for Dojolvi with molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD). Submit through CoverMyMeds or ExpressPAth with genetic test results, diagnosis codes, and clinical rationale. If denied, Virginia law provides step therapy override protections and