Topic

Florida

A collection of 396 issues

How to Get Strensiq (Asfotase Alfa) Covered by Cigna in Florida: Prior Authorization Guide and Appeals Strategy

Answer Box: Getting Strensiq Covered by Cigna in Florida Strensiq (asfotase alfa) requires prior authorization from Cigna for hypophosphatasia (HPP) treatment. No step therapy is required since no alternatives exist. Key requirements: genetic testing showing ALPL mutation, low serum alkaline phosphatase, and pediatric-onset HPP documentation. First step: Have your specialist

Renewing Soliris (Eculizumab) Approval with Blue Cross Blue Shield in Florida: Complete 2025 Guide with Forms and Timelines

Answer Box: Renewing Soliris Coverage in Florida Florida Blue Cross Blue Shield requires annual Soliris (eculizumab) renewal with updated clinical documentation 30-60 days before expiration. Key requirements include: current lab results showing disease response, up-to-date meningococcal vaccination records, REMS compliance documentation, and step therapy completion records. Submit via Availity.com

Sylvant (Siltuximab) Coverage by UnitedHealthcare in Florida: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Sylvant Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Sylvant (siltuximab) in Florida. The fastest path to approval: (1) Gather HIV-negative and HHV-8-negative lab results, pathology confirming multicentric Castleman disease, and clinical notes; (2) Submit PA through the UnitedHealthcare Provider Portal with complete documentation; (3)

Getting Acthar Gel Covered by Blue Cross Blue Shield in Florida: Prior Authorization Guide and Appeal Process

Answer Box: Getting Acthar Gel Approved by Florida Blue Cross Blue Shield Florida Blue requires prior authorization for Acthar Gel and enforces strict step therapy with corticosteroids. To get coverage: (1) Document failed trials of prednisone/methylprednisolone with specific dates, doses, and outcomes, (2) Submit PA request through Florida Blue

Myths vs. Facts: Getting Trikafta Covered by UnitedHealthcare in Florida (Complete Appeals Guide with Forms and Timelines)

Answer Box: Getting Trikafta Covered by UnitedHealthcare in Florida Key Facts: UnitedHealthcare covers Trikafta for CF patients aged 2+ with documented F508del or responsive CFTR mutations. Prior authorization is required through OptumRx specialty pharmacy network. First step: Verify your genetic test results are complete and contact your CF specialist to

How to Get Vanflyta (quizartinib) Covered by Cigna in Florida: ICD-10, HCPCS, and Appeal Guide

Answer Box: Getting Vanflyta (quizartinib) Covered by Cigna in Florida Vanflyta requires prior authorization from Cigna in Florida. The fastest path: Submit PA with FLT3-ITD lab results, ICD-10 code C92.00 (AML not in remission), and HCPCS J8999 for billing. If denied, you have 180 days for internal appeal, then

How to Get Myozyme (Alglucosidase Alfa) Covered by UnitedHealthcare in Florida: Complete Appeals Guide with Forms and Timelines

Quick Answer: UnitedHealthcare requires prior authorization for Myozyme (alglucosidase alfa) in Florida through OptumRx. Success requires confirmed Pompe disease diagnosis (genetic testing + enzyme deficiency), specialist evaluation, and complete clinical documentation. If denied, Florida law provides 180 days for internal appeals and external review through the Department of Financial Services. Start

How to Get Adynovate Covered by Florida Blue Cross Blue Shield: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Adynovate Covered by Florida Blue Cross Blue Shield Florida Blue requires prior authorization for Adynovate (bdanocog alfa pegol) for hemophilia A treatment. The fastest path to approval: 1) Confirm your plan's specialty pharmacy network, 2) Have your hematologist submit a complete prior authorization request via

How to Get HyperHEP (Hepatitis B Immune Globulin) Covered by Humana in Florida: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: HyperHEP requires prior authorization from Humana in Florida. Submit PA requests via the Humana provider portal with exposure documentation, immunity status, and timing within 24 hours of exposure. If denied, you have 65 days for internal appeals and 60 days for external review. Medicare patients cannot use manufacturer

How to Get Ferriprox (deferiprone) Covered by UnitedHealthcare in Florida: Complete Prior Authorization and Appeal Guide

Answer Box: Quick Path to Ferriprox Coverage UnitedHealthcare requires prior authorization for Ferriprox (deferiprone) as a Tier 5 specialty drug in Florida. Your fastest path: 1) Gather diagnosis documentation (transfusional iron overload), lab results (ferritin >1000 ng/mL), and proof of failed/contraindicated alternatives (deferasirox or deferoxamine). 2) Submit