Topic

Dojolvi (triheptanoin)

A collection of 33 issues

Denied for Dojolvi (Triheptanoin) by UnitedHealthcare in New Jersey? Complete Appeal Guide with Templates

Answer Box: UnitedHealthcare requires prior authorization for Dojolvi (triheptanoin) with molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD) and specialist prescription. No step therapy applies. If denied, request peer-to-peer review immediately, then file internal appeal within 180 days. After exhausting internal appeals, use New Jersey's IHCAP external

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

Quick Answer: Getting Dojolvi Covered by Aetna CVS Health in Virginia Dojolvi (triheptanoin) requires prior authorization and formulary exception from Aetna CVS Health. You'll need molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD), specialist prescription, and documentation that other MCT products have been discontinued. The fastest path:

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