Topic

Insurance Approval

A collection of 692 issues

Renewing Vigabatrin (Sabril) Approval with Aetna CVS Health in California: Timeline, Documents & What to Prepare

Answer Box: Vigabatrin Renewal with Aetna CVS Health in California Vigabatrin (Sabril) prior authorization renewal with Aetna CVS Health requires documentation of continued seizure response (≥50% reduction from baseline), ongoing REMS program compliance with vision monitoring every 3 months, and submission 30-60 days before current approval expires. Start by gathering

How Long Does It Take to Get Turalio (Pexidartinib) Approved by UnitedHealthcare in Texas? Complete Timeline Guide

Answer Box: Getting Turalio Approved by UnitedHealthcare in Texas Timeline: 7-30 days for standard review, 72 hours for expedited cases. Fastest path: Complete REMS enrollment first, gather surgical consultation notes explaining why surgery isn't feasible, and submit prior authorization with comprehensive TGCT documentation through the UnitedHealthcare provider portal.

How Long Does It Take to Get Rylaze Approved by UnitedHealthcare in New Jersey? Complete Timeline Guide

Answer Box: Getting Rylaze Approved by UnitedHealthcare in New Jersey Fastest approval path: Submit prior authorization with complete hypersensitivity documentation to E. coli asparaginase within 24-72 hours. UnitedHealthcare requires oncologist prescription, ALL/LBL diagnosis proof, and detailed allergy records. If denied, New Jersey's IHCAP external review provides binding

How to Get Darzalex Covered by Cigna in New York: Appeal Templates, Timelines & Prior Authorization Guide

Answer Box: Getting Darzalex Covered by Cigna in New York If Cigna denies Darzalex (daratumumab) coverage, you can appeal within 180 days. Most denials stem from insufficient prior therapy documentation or missing age verification (≥18 required). Quick action steps: 1) Call Cigna at 1-800-882-4462 for clarification, 2) Gather complete treatment

How to Get Orladeyo (Berotralstat) Covered by Humana in Washington: Timeline, Appeals & Forms

Answer Box: Getting Orladeyo Covered by Humana in Washington Orladeyo (berotralstat) is typically covered by Humana as a specialty tier drug requiring prior authorization for hereditary angioedema (HAE) prophylaxis. The fastest path to approval involves: 1) Confirming HAE diagnosis with lab results (C1-INH levels/function), 2) Submitting complete prior authorization

How to Get Soliris (Eculizumab) Covered by UnitedHealthcare in New Jersey: Complete Guide to Prior Authorization, Appeals, and State Protections

Quick Answer: Getting Soliris Covered in New Jersey Eligibility: UnitedHealthcare requires prior authorization for Soliris (eculizumab) with strict documentation of approved conditions (PNH, aHUS, gMG, NMOSD), meningococcal vaccination records, and REMS compliance. Fastest path: Submit PA through UnitedHealthcare provider portal with complete vaccination records and specialist prescription. First step today:

How Long Does It Take to Get Keytruda (Pembrolizumab) Approved by UnitedHealthcare in New York? Complete Timeline Guide

Answer Box: Getting Keytruda Approved by UnitedHealthcare in New York Timeline: 3-5 business days for standard review, 72 hours for expedited cases. Fastest path: Submit complete prior authorization through UnitedHealthcare Provider Portal with NCCN-aligned documentation and required biomarker testing. Start today: Contact your oncologist to gather pathology reports, biomarker results

Renewing Zanzalintinib (XL092) Coverage with Humana in Washington: Timeline, Documentation & Appeal Steps

Answer Box: Renewing Zanzalintinib (XL092) Coverage with Humana in Washington Zanzalintinib (XL092) is an investigational drug requiring compassionate use program enrollment through Exelixis, as it's not FDA-approved. Humana typically covers investigational drugs only within clinical trials or approved compassionate use programs. To renew coverage: (1) Confirm continued eligibility

How to Get Strensiq (asfotase alfa) Covered by Cigna in Illinois: Decision Tree, Appeals, and Next Steps

Answer Box: Your Path to Strensiq Coverage in Illinois Cigna requires strict prior authorization for Strensiq (asfotase alfa) for pediatric-onset hypophosphatasia (HPP). You qualify if you have documented perinatal, infantile, or juvenile-onset HPP with low alkaline phosphatase and genetic confirmation. Next steps: (1) Gather diagnostic proof including ALPL mutation testing,

Garadacimab (Andembry) Coverage by Humana in Texas: Formulary Alternatives, Appeals, and Prior Authorization Guide

Quick Answer: Getting Garadacimab (Andembry) Covered by Humana in Texas Garadacimab is not on Humana's 2025 Medicare formulary, requiring a formulary exception request. Texas residents have strong appeal rights through internal reviews (65 days to file) and external reviews via Independent Review Organizations. First step: Have your prescriber