Topic

Givlaari (givosiran)

A collection of 20 issues

How to Get Givlaari (givosiran) Covered by Aetna CVS Health in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Givlaari Covered by Aetna CVS Health in Pennsylvania Yes, Givlaari (givosiran) can be covered by Aetna CVS Health in Pennsylvania, but requires prior authorization. Submit your PA request through Availity.com with complete AHP documentation including elevated ALA/PBG levels and attack history. If denied, Pennsylvania'

How to Get Givlaari (givosiran) Covered by Aetna (CVS Health) in Illinois: Prior Authorization Guide and Appeal Process

Answer Box: Getting Givlaari Covered by Aetna in Illinois Aetna (CVS Health) requires prior authorization for Givlaari (givosiran) with documentation of at least 4 acute hepatic porphyria attacks per year and elevated urine ALA/PBG levels. Submit requests via phone (855-582-2025), fax (855-330-1716), or mail to Aetna PA, 1300 E.

Renewing Givlaari (Givosiran) Approval with UnitedHealthcare in California: Complete 2025 Guide

Answer Box: To renew Givlaari (givosiran) with UnitedHealthcare in California, submit annual prior authorization 30-45 days before expiration with: (1) Recent ALA/PBG lab values, (2) documented attack reduction from baseline, (3) specialist attestation of ongoing medical necessity, and (4) liver function monitoring results. Use the UnitedHealthcare provider portal for

How to Get Givlaari (Givosiran) Covered by UnitedHealthcare in Florida: Complete Prior Authorization Guide

Answer Box: Getting Givlaari Covered by UnitedHealthcare in Florida To get Givlaari (givosiran) covered by UnitedHealthcare in Florida, you must document acute hepatic porphyria with at least 2 qualifying attacks in the past 6 months, show failure/intolerance to hemin therapy, and obtain specialist prescribing. Submit prior authorization through the

How to Get Givlaari (givosiran) Covered by UnitedHealthcare in Texas: Complete Coding and Appeals Guide

Answer Box: To get Givlaari (givosiran) covered by UnitedHealthcare in Texas, you need prior authorization with specific documentation: confirmed acute hepatic porphyria diagnosis (ICD-10 E80.21), elevated ALA/PBG lab results, at least 2 documented attacks in 6 months, and evidence of hemin failure/intolerance. Submit via the UnitedHealthcare Provider

Do You Qualify for Givlaari (givosiran) Coverage by Humana in New Jersey? Decision Tree & Next Steps

Answer Box: Getting Givlaari Covered by Humana in New Jersey Most likely to qualify: Adults with confirmed acute hepatic porphyria (AHP) who've had 2+ attacks in 6 months, elevated ALA/PBG levels, and a hematologist/hepatologist prescriber. Fastest path: Submit prior authorization with attack history, lab results, and

How to Get Givlaari (givosiran) Covered by Humana in California: Complete Appeals Guide with Templates

Quick Answer: Getting Givlaari Approved by Humana in California Givlaari (givosiran) requires prior authorization from Humana, typically requiring documented acute hepatic porphyria (AHP) with elevated ALA/PBG levels, ≥2 attacks in 6 months, and specialist involvement. If denied, you have 65 days to appeal and can request California's

Aetna CVS Health Coverage for Givlaari (Givosiran) in Virginia: Medical Necessity Criteria and Appeals Guide

Quick Answer: Getting Givlaari (Givosiran) Covered by Aetna CVS Health in Virginia Aetna requires prior authorization for Givlaari through CVS Specialty Pharmacy. Key requirements: confirmed acute hepatic porphyria with elevated ALA/PBG levels, 4+ attacks per year or active symptoms requiring hospitalization/hemin, age 18+, and specialist prescriber. Submit via

How to Get Givlaari (Givosiran) Covered by Blue Cross Blue Shield in Georgia: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Givlaari Approved in Georgia Blue Cross Blue Shield Georgia requires prior authorization for Givlaari (givosiran) with strict clinical criteria. You'll need documented acute hepatic porphyria diagnosis, elevated ALA/PBG levels, and at least 2 attacks in 6 months. Submit through the BCBS provider portal with

How to Get Givlaari (givosiran) Covered by Cigna in Virginia: Complete Coding, Appeals & External Review Guide

Quick Answer: Getting Givlaari (givosiran) Covered by Cigna in Virginia Eligibility: Adults with acute hepatic porphyria (AHP) who have documented elevated ALA/PBG levels and ≥2 attacks in 6 months. Fastest path: Have your specialist submit prior authorization with ICD-10 code E80.21, attack logs, and lab results showing elevated