Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1121 issues

How Long Does It Take to Get Oxervate (Cenegermin) Approved by UnitedHealthcare in Pennsylvania? Complete Timeline & Appeals Guide

Answer Box: Getting Oxervate Approved by UnitedHealthcare in Pennsylvania Timeline: UnitedHealthcare typically decides prior authorization requests within 5-14 business days, though OptumRx's automated system can approve qualifying requests in under 30 seconds. Key requirements: Stage 2 or 3 neurotrophic keratitis diagnosis, documented failure of at least one OTC
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Getting Signifor LAR (Pasireotide) Covered by UnitedHealthcare in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Approval UnitedHealthcare requires prior authorization for Signifor LAR (pasireotide) with specific criteria: confirmed endogenous Cushing's disease and documentation that pituitary surgery was non-curative or not viable. No step therapy required. Your board-certified endocrinologist must submit through OptumRx with biochemical proof (abnormal UFC or
5 min read

How to Get Tysabri (Natalizumab) Covered by UnitedHealthcare in Washington: Appeals, Prior Authorization & State Protections

Quick Answer: Getting Tysabri Covered in Washington UnitedHealthcare requires prior authorization for Tysabri (natalizumab) through OptumRx before dispensing. You must be enrolled in the FDA-required TOUCH program and provide documentation of multiple sclerosis diagnosis with prior treatment failures. If denied, you have 180 days to file an internal appeal, followed
6 min read

How to Get Uplizna (Inebilizumab) Covered by UnitedHealthcare in New Jersey: Prior Authorization, Appeals, and State Protections

Answer Box: Getting Uplizna Covered by UnitedHealthcare in New Jersey Uplizna (inebilizumab) requires prior authorization from UnitedHealthcare for both NMOSD and IgG4-related disease. Submit through the UnitedHealthcare Provider Portal with specialist documentation, AQP4-IgG test results, and prior treatment history. If denied, you have 180 days to appeal internally, then can
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How to Get Upstaza (Eladocagene Exuparvovec) Approved by UnitedHealthcare in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Upstaza Covered by UnitedHealthcare in North Carolina To get Upstaza (eladocagene exuparvovec) approved by UnitedHealthcare in North Carolina, you need: (1) genetic confirmation of biallelic DDC mutations from a CLIA-certified lab, (2) biochemical evidence (AADC enzyme activity <50% normal or abnormal CSF profile), and (3) treatment
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How to Get Hetlioz LQ Covered by UnitedHealthcare in Pennsylvania: Appeals Guide & Templates

Answer Box: Getting Hetlioz LQ Covered by UnitedHealthcare in Pennsylvania Quick Path to Approval: UnitedHealthcare requires prior authorization for Hetlioz LQ through OptumRx. Your child must be 3-15 years old with genetically confirmed Smith-Magenis Syndrome and documented sleep disturbances. Submit through the UnitedHealthcare Provider Portal with genetic testing results, specialist
6 min read

How to Get Filspari (Sparsentan) Covered by UnitedHealthcare in Ohio: Complete Guide with Forms, Appeals, and State Resources

Quick Answer: Getting Filspari (Sparsentan) Covered by UnitedHealthcare in Ohio Fastest path to approval: Submit prior authorization through UnitedHealthcare's provider portal with complete IgA nephropathy documentation, REMS enrollment, and evidence of failed glucocorticoids/SGLT2 inhibitors. Standard reviews complete in 72 hours; expedited in 24 hours. If denied, you
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Work With Your Doctor to Get Haegarda Covered by UnitedHealthcare in New Jersey: Provider Partnership Guide

Answer Box: Getting Haegarda Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Haegarda (C1-esterase inhibitor, SC) with strict documentation requirements. Success depends on partnering with an immunologist or allergist who can demonstrate confirmed HAE diagnosis, attack frequency justifying prophylaxis, and failure of preferred alternatives. In New Jersey,
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How to Get StrataGraft Covered by UnitedHealthcare in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting StrataGraft Covered by UnitedHealthcare in North Carolina StrataGraft requires prior authorization from UnitedHealthcare as a facility-billed medical benefit (not pharmacy) for deep partial-thickness thermal burns. Start by having your burn specialist submit complete documentation through the UnitedHealthcare Provider Portal. If denied, you have 180 days for internal
5 min read