Topic

Lutathera (lutetium Lu-177 dotatate)

A collection of 14 issues

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by UnitedHealthcare in Ohio: Complete Appeals Guide with Templates

Answer Box: Getting Lutathera Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Lutathera (lutetium Lu-177 dotatate) with mandatory step therapy documentation showing progression on somatostatin analogs. In Ohio, you have 60 days to appeal denials internally, then 180 days for external review through the Ohio Department of Insurance.
6 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Provider Collaboration Guide

Answer Box: Getting Lutathera Covered by Blue Cross Blue Shield in Pennsylvania Blue Cross Blue Shield plans in Pennsylvania (Highmark, Independence Blue Cross) require prior authorization for Lutathera (lutetium Lu-177 dotatate) with strict clinical criteria. Fastest approval path: Confirm you have GEP-NET diagnosis with SSTR-positive imaging, documented octreotide/lanreotide failure,
6 min read

Work With Your Doctor to Get Lutathera (Lutetium Lu-177 Dotatate) Approved by UnitedHealthcare in Pennsylvania: Complete Provider Collaboration Guide

Quick Answer: Your Path to Lutathera Approval To get Lutathera (lutetium Lu-177 dotatate) covered by UnitedHealthcare in Pennsylvania, you'll need prior authorization showing somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors and documented progression on octreotide or lanreotide. Start today by: (1) requesting your complete medical records from your oncologist, (2)
6 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by UnitedHealthcare in North Carolina: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Lutathera Covered by UnitedHealthcare in North Carolina Lutathera requires prior authorization from UnitedHealthcare with strict step therapy requirements. You must show disease progression on octreotide LAR or lanreotide, plus SSTR-positive imaging (Ga-68 DOTATATE PET scan). If denied, appeals succeed in 85% of cases. Start today: Gather your
5 min read

Resources to Get Lutathera (Lutetium Lu-177 Dotatate) Approved with UnitedHealthcare in Washington: Forms, Portals & Appeals Guide

Answer Box: Getting Lutathera Covered by UnitedHealthcare in Washington Lutathera requires prior authorization from UnitedHealthcare with strict clinical criteria. The fastest path: Submit through the UnitedHealthcare Provider Portal with complete documentation including SSTR-positive imaging, GEP-NET diagnosis, and disease progression on octreotide. If denied, file internal appeals within 180 days, then
5 min read

How to Get Lutathera (lutetium Lu-177 dotatate) Approved by Cigna in Georgia: Timeline, Forms & Appeal Process

Answer Box: Getting Lutathera Covered by Cigna in Georgia Cigna typically approves Lutathera (lutetium Lu-177 dotatate) within 2 business days when complete documentation is submitted electronically through Accredo's prior authorization portal. Key requirements: confirmed somatostatin receptor-positive imaging, documented progression on somatostatin analogs, and nuclear medicine facility certification. If
5 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by UnitedHealthcare in Virginia: Prior Authorization, Appeals & Forms

Quick Answer: Getting Lutathera Covered by UnitedHealthcare in Virginia Lutathera requires prior authorization from UnitedHealthcare OptumRx in Virginia. Your oncologist must submit clinical documentation proving somatostatin receptor positivity, appropriate tumor grading, and progression on octreotide/lanreotide. If denied, you have 180 days for internal appeals, then 120 days to file
5 min read

Myths vs. Facts: Getting Lutathera (Lutetium Lu-177 Dotatate) Covered by Aetna CVS Health in Virginia

Answer Box: Lutathera Coverage by Aetna CVS Health in Virginia Eligibility: Adults and pediatric patients ≥12 years with SSTR-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that are unresectable, locally advanced, or metastatic. Fastest Path: Submit prior authorization through Aetna provider portal with complete documentation: pathology report, SSTR-positive imaging (Ga-68 DOTATATE PET), prior
6 min read