Topic

New York

A collection of 422 issues

How to Get Cystadane (Betaine Anhydrous) Covered by Cigna in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Cystadane Approved by Cigna in New York Eligibility: Cystadane (betaine anhydrous) requires prior authorization from Cigna for homocystinuria with genetic/biochemical confirmation, specialist prescribing, and documented vitamin co-therapy plan. Fastest path: Submit PA through Cigna provider portal with genetic testing results, elevated homocysteine levels, and medical necessity

How to Get Oxervate (Cenegermin) Covered by UnitedHealthcare in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Get Oxervate Covered by UnitedHealthcare in New York UnitedHealthcare requires prior authorization for Oxervate (cenegermin) with specific criteria: confirmed Stage 2 or 3 neurotrophic keratitis diagnosis and documented failure of at least one OTC artificial tear product. Submit PA through the OptumRx portal or fax to 1-844-403-1027. If

How to Get Sumatriptan Injection Covered by UnitedHealthcare in New York: Prior Authorization Guide & Appeal Templates

Quick Answer: Getting Sumatriptan Injection Covered by UnitedHealthcare in New York Note: Sumavel DosePro was discontinued in the U.S. UnitedHealthcare now covers generic sumatriptan injection auto-injectors with prior authorization. You'll need to document failed oral triptan trials and medical necessity for injectable route. If denied, you have

How to Get Zolgensma Covered by Blue Cross Blue Shield in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Zolgensma Covered by Blue Cross Blue Shield in New York Yes, Blue Cross Blue Shield plans in New York do cover Zolgensma for eligible children with spinal muscular atrophy (SMA). The fastest path to approval requires three key steps: 1) Confirm genetic testing shows bi-allelic SMN1 mutation

Getting Translarna (Ataluren) Covered by Blue Cross Blue Shield in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Started with Translarna Coverage Blue Cross Blue Shield plans in New York typically require prior authorization for Translarna (ataluren) and often list it as non-formulary due to its regulatory status. Success depends on having complete genetic documentation (nonsense mutation DMD), ambulatory status confirmation, and specialist prescriber involvement.

How to Get Somatuline Depot (Lanreotide) Covered by Humana in New York: Prior Authorization, Appeals, and Cost Assistance Guide

Answer Box: Getting Somatuline Depot Covered by Humana in New York Fastest path to approval: Submit Humana's prior authorization form with diagnosis (acromegaly, GEP-NET, or carcinoid syndrome), prior therapy documentation, and clinical justification. Humana typically covers Somatuline Depot on specialty tier with PA required. If denied, you have

How to Get iLink® Corneal Cross-Linking Covered by Blue Cross Blue Shield in New York: Prior Authorization Forms, Appeals Process, and Success Strategies

Quick Answer: Getting iLink® Covered by BCBS in New York Blue Cross Blue Shield plans in New York generally cover FDA-approved epithelium-off iLink® corneal cross-linking for progressive keratoconus when medical necessity criteria are met. Submit prior authorization through Availity (most plans) with documented progression evidence. If denied, New York'

How to Get Tavneos (Avacopan) Covered by Blue Cross Blue Shield in New York: Complete Guide to Prior Authorization, Appeals, and Billing Codes

Answer Box: Getting Tavneos Covered by Blue Cross Blue Shield in New York To get Tavneos (avacopan) covered by Blue Cross Blue Shield in New York, you'll need prior authorization with documented severe active ANCA-associated vasculitis (GPA or MPA), use as adjunctive therapy with standard immunosuppressants, and prescription

Renewing StrataGraft Coverage with Blue Cross Blue Shield in New York: Complete Guide to Documentation, Timelines, and Appeals

Answer Box: Getting StrataGraft Renewal Approved by Blue Cross Blue Shield in New York StrataGraft renewals require prior authorization as a facility-billed medical service through Blue Cross Blue Shield plans in New York (Anthem, Empire, Excellus, BCBS of WNY). Start renewal requests 2-3 weeks before your next treatment date. Submit

How to Get Chenodal (Chenodiol) Covered by UnitedHealthcare in New York: Complete Guide with Forms, Appeals, and Step-by-Step Process

Answer Box: Getting Chenodal (Chenodiol) Covered by UnitedHealthcare in New York Current Coverage Status: UnitedHealthcare requires prior authorization for Chenodal (chenodiol) but coverage is now restricted to cerebrotendinous xanthomatosis (CTX) only. Gallstone dissolution is no longer a covered indication. Fastest Path to Approval: 1. Confirm CTX diagnosis with genetic testing