Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1133 issues

How to Get Tecentriq (atezolizumab) Covered by UnitedHealthcare in Virginia: Complete Coding, Appeals, and Authorization Guide

Answer Box: Getting Tecentriq Covered by UnitedHealthcare in Virginia Tecentriq (atezolizumab) requires prior authorization from UnitedHealthcare and follows medical benefit billing using HCPCS code J9022. Your fastest path to approval: 1) Submit PA request with required PD-L1 testing results and proper ICD-10 codes (C34.x for lung cancer, C22.0

Work With Your Doctor to Get Juxtapid (lomitapide) Approved by UnitedHealthcare in Florida: Provider Collaboration Guide

Quick Answer: Getting Juxtapid Approved Through UnitedHealthcare in Florida Juxtapid (lomitapide) requires strict prior authorization from UnitedHealthcare, including documented failure of Repatha and Evkeeza, REMS program compliance, and specialist prescribing. Your doctor must submit genetic confirmation of homozygous familial hypercholesterolemia (HoFH), baseline liver function tests, and proof of low-fat diet

How to Get Thiola (Tiopronin) Covered by UnitedHealthcare in Illinois: Complete Appeal Guide with Forms & Timelines

Quick Answer: Getting Thiola Covered by UnitedHealthcare in Illinois Fast track to approval: UnitedHealthcare requires prior authorization for Thiola (tiopronin) with documented cystinuria diagnosis, 24-hour urine cystine >250-300 mg/day, and failure of conservative therapy (alkalinization, high fluid intake) for 3+ months. Submit through OptumRx with specialist documentation. If

Myths vs. Facts: Getting Turalio (pexidartinib) Covered by UnitedHealthcare in Washington

Quick Answer: Getting Turalio (pexidartinib) covered by UnitedHealthcare in Washington requires REMS program enrollment, confirmed TGCT diagnosis, and documentation that surgery isn't viable. Most denials stem from incomplete REMS forms or missing surgical consultation notes. If denied, Washington's external review process through an Independent Review Organization

Renewing Ocrevus (Ocrelizumab) Approval with UnitedHealthcare in Illinois: Complete 2025 Guide

Quick Answer: Ocrevus Renewal with UnitedHealthcare in Illinois UnitedHealthcare requires annual renewal documentation for Ocrevus (ocrelizumab) showing positive clinical response and compliance with safety monitoring. Start your renewal process 6-8 weeks before your current authorization expires. Key requirements: updated MRI showing disease stability, documentation of adherence, current lab work (especially

Getting Raxone (Idebenone) Covered by UnitedHealthcare in New Jersey: Prior Authorization Guide and Appeal Process

Answer Box: Getting Raxone Covered by UnitedHealthcare in New Jersey Raxone (idebenone) requires prior authorization from UnitedHealthcare and faces coverage challenges since it's not FDA-approved in the US. Your fastest path: 1) Submit a comprehensive medical exception request through OptumRx with clinical trial evidence and failed alternative documentation,

Do You Qualify for Elzonris Coverage by UnitedHealthcare in Ohio? Complete Decision Tree & Appeal Guide

Quick Answer: Your Path to Elzonris Coverage Yes, you can get Elzonris (tagraxofusp-erzs) covered by UnitedHealthcare in Ohio if you have confirmed BPDCN with CD123+ pathology. UnitedHealthcare requires prior authorization through OptumRx, but step therapy is typically not required for this ultra-rare condition. First step today: Gather your pathology report

Coding That Helps Get Haegarda Covered by UnitedHealthcare in Texas: ICD-10, J-Code, and NDC Requirements

Answer Box: Getting Haegarda Covered by UnitedHealthcare in Texas Fastest Path: Submit prior authorization with ICD-10 code D84.1 (hereditary angioedema), specialist documentation, and lab evidence of C1-INH deficiency. Use J-code J0599 for billing (10 units per code). UnitedHealthcare requires specialist prescriber and confirmed HAE diagnosis—no absolute step therapy

Work With Your Doctor to Get Tegsedi (inotersen) Approved by UnitedHealthcare in Virginia: Complete Prior Authorization Guide

Quick Answer: Getting Tegsedi (inotersen) covered by UnitedHealthcare in Virginia requires genetic confirmation of hATTR polyneuropathy, REMS program enrollment, and documented failure of Onpattro (step therapy). Start by scheduling a visit with your neurologist to review diagnostic requirements and gather clinical documentation. If denied, Virginia's Bureau of Insurance

How to Get Natpara (Parathyroid Hormone) Covered by UnitedHealthcare in Pennsylvania: 2025 Discontinuation Guide

Quick Answer: Natpara Coverage Status in Pennsylvania Natpara (parathyroid hormone) is being discontinued globally by Takeda as of December 31, 2024. UnitedHealthcare in Pennsylvania will only cover existing patients through December 2025, with no new patient starts allowed. If you're currently on Natpara, work with your endocrinologist immediately