Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1058 issues

Work With Your Doctor to Get Opdivo (nivolumab) Approved by UnitedHealthcare in Ohio: Complete Provider Collaboration Guide

Answer Box: Your Path to Opdivo Approval Getting Opdivo (nivolumab) covered by UnitedHealthcare in Ohio requires prior authorization with specific biomarker testing and clinical documentation. Work with your oncologist to submit evidence through UnitedHealthcare's provider portal, request peer-to-peer review if denied (~85% overturn rate), and use Ohio'
6 min read

Myths vs. Facts: Getting Uplizna (Inebilizumab) Covered by UnitedHealthcare in California

Quick Answer: UnitedHealthcare requires prior authorization for Uplizna (inebilizumab) in California with specific documentation: AQP4-positive NMOSD diagnosis, neurologist prescription, HBV screening, and often step therapy with eculizumab first. If denied, file internal appeal within 180 days, then California's Independent Medical Review (IMR) through DMHC. Start by gathering AQP4-IgG
5 min read

How to Get Stelara (Ustekinumab) Covered by UnitedHealthcare in Washington: Complete Guide to Prior Authorization, Appeals, and Medical Necessity Letters

Answer Box: Your Path to Stelara Coverage in Washington UnitedHealthcare requires prior authorization for brand Stelara (ustekinumab) with step therapy through biosimilars first. In Washington, if denied, you have 180 days for internal appeals plus external review through an Independent Review Organization. Start today: Have your doctor submit a medical
6 min read

Get Waylivra (Volanesorsen) Covered by UnitedHealthcare in Florida: Complete Guide to Forms, Appeals, and Approval

Quick Answer: Getting Waylivra Covered in Florida Waylivra (volanesorsen) requires prior authorization through UnitedHealthcare's OptumRx system in Florida. Submit PA requests via the UnitedHealthcare Provider Portal with confirmed FCS diagnosis, triglyceride levels >880 mg/dL, and prior therapy documentation. If denied, file internal appeals within 180 days,
6 min read

How to Get Rezlidhia (olutasidenib) Covered by UnitedHealthcare in Pennsylvania: Prior Authorization, Appeals, and Renewal Guide

Answer Box: Getting Rezlidhia (olutasidenib) covered by UnitedHealthcare in Pennsylvania requires prior authorization with IDH1 mutation testing, documented AML diagnosis, and prior therapy history. If denied, you have 180 days for internal appeals, then 4 months for Pennsylvania's external review (50% overturn rate). Start by having your oncologist
6 min read

How to Get Fabrazyme (agalsidase beta) Covered by UnitedHealthcare in Texas: Prior Authorization, Appeals, and Alternative Paths

Answer Box: Getting Fabrazyme Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Fabrazyme (agalsidase beta) with 12-month approvals based on confirmed Fabry disease diagnosis, genetic testing, and treatment response documentation. Fastest path: Submit PA through OptumRx with specialist letter, recent labs, and genetic confirmation 30 days before needed.
6 min read

The Requirements Checklist to Get Rinvoq (Upadacitinib) Covered by UnitedHealthcare in Georgia: Prior Authorization, Appeals, and Documentation Guide

Answer Box: Getting Rinvoq Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Rinvoq (upadacitinib) with documented failure of at least one TNF inhibitor for most inflammatory conditions. The fastest path to approval: (1) Submit the UnitedHealthcare Rinvoq medical necessity form with detailed prior therapy documentation, (2) Include a
6 min read

How to Get Strensiq (asfotase alfa) Covered by UnitedHealthcare in Ohio: Complete PA Guide with Forms and Appeals

Answer Box: Quick Path to Strensiq Coverage UnitedHealthcare requires prior authorization for Strensiq (asfotase alfa) with specific documentation of perinatal/infantile or juvenile-onset hypophosphatasia. Key requirements: persistent low alkaline phosphatase, elevated substrate markers (PLP/PEA), clinical/radiographic features, and prescribing by an endocrinologist or metabolic bone specialist. First step today:
6 min read