Topic

New York

A collection of 443 issues

How to Get Ferriprox (Deferiprone) Covered by Cigna in New York: Complete Guide to Prior Authorization and Appeals

Answer Box: Fastest Path to Ferriprox Approval in New York Is Ferriprox covered by Cigna? Yes, but requires prior authorization with specific medical criteria. Fastest approval path: 1) Confirm your diagnosis of transfusional iron overload with documented ferritin levels >1,000 ng/mL, 2) Have your doctor submit prior

Get Luxturna Covered by Blue Cross Blue Shield in New York: Complete Provider Partnership Guide

Answer Box: Getting Luxturna Covered by Blue Cross Blue Shield in New York Eligibility: Confirmed biallelic RPE65 mutations + viable retinal cells (>100 microns thickness) + treatment at qualified center. Fastest path: Partner with your retinal specialist to submit comprehensive prior authorization with genetic test results, OCT scans, and medical necessity

How to Get Taltz (ixekizumab) Covered by Cigna in New York: Prior Authorization, Appeals & Success Tips

Quick Answer: Taltz (ixekizumab) requires prior authorization from Cigna in New York and sits on Tier 4 as a specialty medication. Your fastest path to approval: (1) Have your doctor document failed conventional therapies like methotrexate, (2) submit Cigna's PA form with clinical notes showing disease severity, and

How to Get Duopa Covered by Humana in New York: Complete Prior Authorization Guide

Answer Box: To get Duopa covered by Humana in New York, you need prior authorization showing advanced Parkinson's disease with motor fluctuations despite optimized oral therapy. The fastest path: (1) Document 3+ hours daily "OFF" time with patient diaries, (2) Submit PA request through Humana'

Getting Exondys 51 (Eteplirsen) Covered by Blue Cross Blue Shield in New York: Complete PA Guide

Answer Box: Quick Path to Coverage Exondys 51 (eteplirsen) requires prior authorization from Blue Cross Blue Shield in New York. Your fastest path: 1) Confirm genetic testing shows DMD with exon 51 mutation amenable to skipping, 2) Have a pediatric neurologist or neuromuscular specialist complete the BCBS Medical Authorization Request

How to Get Nourianz (Istradefylline) Covered by Aetna CVS Health in New York: Complete Guide to Prior Authorization, Appeals, and State Protections

Answer Box: Getting Nourianz Covered by Aetna CVS Health in New York Fastest Path to Approval: Nourianz (istradefylline) typically requires prior authorization from Aetna CVS Health, with step therapy requiring trials of other Parkinson's adjunct medications first. New York law provides strong protections: you can request a step

Renewing Fabrazyme (Agalsidase Beta) Approval with Aetna CVS Health in New York: Complete Timeline and Documentation Guide

Answer Box: Renewing Fabrazyme with Aetna CVS Health in New York Quick Path to Renewal: Submit your Fabrazyme (agalsidase beta) renewal request at least two weeks before your current authorization expires. Include updated clinical notes, recent lab results (GL-3 levels, kidney function), and treatment response documentation. Use the Availity provider

How to Renew Busulfex (Busulfan Injection) Approval with UnitedHealthcare in New York: Timeline, Documentation & Appeal Rights

Answer Box: Renewing Busulfex Coverage with UnitedHealthcare in New York UnitedHealthcare requires reauthorization for Busulfex (busulfan injection) every 6-12 months with comprehensive clinical documentation. Start renewal requests 4 weeks before expiration to avoid treatment gaps. Required documents include recent office notes, lab results showing therapeutic response, and confirmation of continued

How to Get Zanzalintinib (XL092) Covered by Cigna in New York: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Zanzalintinib (XL092) Covered by Cigna in New York Fastest path: Zanzalintinib (XL092) requires prior authorization through Cigna's formulary exception process since it's investigational. Your oncologist must submit clinical rationale documenting medical necessity and failed standard treatments. If denied, file internal appeals within 180

Denied for Evrysdi (Risdiplam) by Humana in New York? How to Appeal (Forms, Templates & Timelines)

Answer Box: Getting Evrysdi (Risdiplam) Covered by Humana in New York If Humana denied Evrysdi (risdiplam) for SMA treatment, you have strong appeal rights in New York. First step: Request internal appeal within 65 days using Humana's exceptions and appeals portal. Include genetic confirmation, baseline motor assessment (CHOP