Topic

Insurance Approval

A collection of 2376 issues

Getting Rapivab (Peramivir) Covered by Cigna in New Jersey: Prior Authorization Guide and Appeals Process

Quick Answer: Rapivab Coverage with Cigna in New Jersey Yes, Cigna covers Rapivab (peramivir) but requires prior authorization and step therapy. You'll need documentation showing symptom onset within 48 hours, a positive flu test, and proof that oral antivirals like Tamiflu aren't suitable. If denied, New

Resources to Get Rylaze Covered by UnitedHealthcare in Texas: Complete Forms, Portals & Contact Guide

Answer Box: Getting Rylaze Covered by UnitedHealthcare in Texas Rylaze requires prior authorization from UnitedHealthcare in Texas. Submit requests through the UnitedHealthcare Provider Portal using drug code J9358, with documented hypersensitivity to E. coli asparaginase. First step today: Verify your specific plan's formulary status and gather hypersensitivity documentation.

Getting Tavalisse (Fostamatinib) Approved by Humana in Georgia: Complete Guide to Prior Authorization and Appeals

Answer Box: Your Path to Tavalisse Coverage in Georgia Tavalisse (fostamatinib) requires prior authorization from Humana and typically isn't on standard formularies. To get coverage in Georgia: (1) Document chronic ITP diagnosis with platelet count <30,000/μL, (2) show failure of corticosteroids and at least one

How to Get Onivyde (irinotecan liposome) Covered by Blue Cross Blue Shield of Texas: Prior Authorization Guide and Appeals Process

Quick Answer: Getting Onivyde Covered by Blue Cross Blue Shield of Texas Blue Cross Blue Shield of Texas requires prior authorization for Onivyde (irinotecan liposome) with mandatory step therapy—you must try and fail conventional irinotecan first. Submit PA requests through Availity Essentials or call the number on your member

How to Get Enhertu Covered by Humana in Ohio: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Enhertu Covered by Humana in Ohio Humana requires prior authorization for Enhertu (fam-trastuzumab deruxtecan-nxki) across all indications. The fastest path to approval: 1) Your oncologist submits a complete prior authorization through Humana's provider portal with HER2 biomarker results, prior therapy documentation, and ILD monitoring plan.

How to Get Voxzogo (Vosoritide) Covered by UnitedHealthcare in Ohio: Complete PA Guide with Forms and Appeal Process

Answer Box: Getting Voxzogo Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Voxzogo (vosoritide) in Ohio. To get approved: (1) Gather genetic testing confirming FGFR3 mutation, bone age X-ray showing open growth plates, and 12+ months of growth data, (2) Have a pediatric endocrinologist or geneticist submit the

How to Get Tremfya (guselkumab) Covered by Cigna in North Carolina: Renewal Guide, Appeals, and Timeline

Answer Box: Renewing Tremfya (guselkumab) with Cigna in North Carolina Cigna requires documented clinical benefit after 6+ months of Tremfya use for renewal authorization, typically approved for 12 months. Submit renewal requests 30-60 days before expiration with objective disease measures (PASI score for psoriasis, joint counts for psoriatic arthritis) and

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

Answer Box: Getting Dupixent Covered by UnitedHealthcare in Florida Fastest path to approval: UnitedHealthcare requires prior authorization for Dupixent through OptumRx, with specific step therapy requirements varying by indication. For atopic dermatitis, avoid concurrent biologics/JAK inhibitors. For asthma, document eosinophilic phenotype (≥150 cells/μL) or oral steroid dependence plus

Renewing iLink® Corneal Cross-Linking Approval with UnitedHealthcare in Florida: Complete Timeline & Documentation Guide

Answer Box: Renewing iLink® Coverage with UnitedHealthcare in Florida UnitedHealthcare requires prior authorization renewal for iLink® corneal cross-linking treatments in Florida, typically needed every 6-12 months or after completing initial treatment phases. Submit renewal requests at least 10 business days before your next scheduled procedure through the UHC Provider Portal.

How to Get Abecma (Idecabtagene Vicleucel) Covered by Blue Cross Blue Shield in Georgia: Appeals, Forms, and State Protections

Quick Answer: Getting Abecma Covered in Georgia Abecma requires prior authorization from Blue Cross Blue Shield in Georgia and must be delivered at an approved Center of Medical Excellence. Your fastest path: 1) Confirm your treatment facility is BCBS-approved for CAR-T therapy, 2) Have your oncologist submit prior authorization with