Topic

HyperHEP (hepatitis B immune globulin)

A collection of 38 issues

UnitedHealthcare's Coverage Criteria for HyperHEP in New Jersey: What Counts as "Medically Necessary"?

Answer Box: Getting HyperHEP Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for HyperHEP (hepatitis B immune globulin) based on documented exposure and timing. Medical necessity requires: (1) exposure to HBsAg-positive blood/fluids within 7 days, (2) patient susceptibility (unvaccinated or non-immune), and (3) proper dosing (0.06

Getting HyperHEP Covered by Cigna in Illinois: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting HyperHEP Covered by Cigna in Illinois HyperHEP (hepatitis B immune globulin) is covered by Cigna as a Tier 4 specialty drug with prior authorization required. In Illinois, you have strong appeal rights including external review within 30 days of denial. Fastest path to approval: 1. Doctor submits

How to Get HyperHEP Covered by Blue Cross Blue Shield of Texas: Forms, Appeals & Contact Guide 2025

Answer Box: Getting HyperHEP Covered by BCBS Texas Quick Path to Coverage: Most Blue Cross Blue Shield of Texas (BCBSTX) plans cover HyperHEP (hepatitis B immune globulin) for post-exposure prophylaxis when administered within 24 hours of exposure. HealthSelect members need no prior authorization as of September 2024, but require a

How to Get HyperHEP (Hepatitis B Immune Globulin) Covered by UnitedHealthcare in Georgia: Prior Authorization Guide and Appeal Scripts

Quick Answer: Getting HyperHEP Covered by UnitedHealthcare in Georgia Yes, UnitedHealthcare covers HyperHEP (hepatitis B immune globulin) in Georgia, but prior authorization is required for most plans. Your fastest path to approval: 1) Submit PA request through OptumRx provider portal within 24-48 hours of exposure, 2) Include CDC post-exposure documentation

How to Get HyperHEP B Covered by Blue Cross Blue Shield in New Jersey: Complete Appeals Guide with Forms and Timelines

Answer Box: HyperHEP (hepatitis B immune globulin) coverage by Blue Cross Blue Shield New Jersey requires prior authorization through MagellanRx Management. Submit PA requests via the Horizon Provider Portal with exposure documentation and clinical justification. If denied, you have 180 days for internal appeals and 4 months for external review

How to Get HyperHEP (Hepatitis B Immune Globulin) Covered by Humana in Virginia: Prior Authorization Guide and Appeal Scripts

Answer Box: HyperHEP Coverage by Humana in Virginia HyperHEP (hepatitis B immune globulin) requires prior authorization from Humana and is typically non-formulary, but coverage is possible with proper documentation. You'll need detailed exposure documentation, proof of timing (within 7 days for needlestick, 14 days for sexual exposure), and

How to Get HyperHEP Covered by UnitedHealthcare in Illinois: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting HyperHEP Covered by UnitedHealthcare in Illinois UnitedHealthcare requires prior authorization for HyperHEP (hepatitis B immune globulin) in Illinois. For fastest approval: (1) Document the exact exposure event and timing within 24 hours, (2) Submit PA through OptumRx with CDC-aligned medical necessity documentation, (3) If denied, file internal

Get HyperHEP Covered by Cigna in Michigan: Appeals Guide and Medical Necessity Templates

Answer Box: Getting HyperHEP Covered by Cigna in Michigan HyperHEP (hepatitis B immune globulin) requires prior authorization from Cigna for post-exposure prophylaxis. To get covered: (1) Your doctor submits a formulary exception request with exposure documentation and CDC guideline references within 24-48 hours of exposure, (2) If denied, file an

How to Get HyperHEP (Hepatitis B Immune Globulin) Covered by Cigna in Ohio: Appeals Guide and Success Templates

Answer Box: Getting HyperHEP Covered by Cigna in Ohio HyperHEP (hepatitis B immune globulin) requires prior authorization from Cigna, with approval based on CDC guidelines for post-exposure prophylaxis. If denied, Ohio residents have 180 days to file internal appeals with Cigna, followed by external review through the Ohio Department of

Coding That Helps Get HyperHEP (Hepatitis B Immune Globulin) Approved by Blue Cross Blue Shield in Ohio: ICD-10, HCPCS, and Medical Necessity

Answer Box: Getting HyperHEP Covered in Ohio HyperHEP (hepatitis B immune globulin) requires prior authorization from Blue Cross Blue Shield in Ohio under the medical benefit. Use HCPCS code 90371 for billing, pair with exposure-specific ICD-10 codes (B19.1 for unspecified HBV exposure), and document clear medical necessity within CDC