Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1133 issues

How Long Does It Take to Get Cosentyx Approved by UnitedHealthcare in Washington? Timeline & Appeal Process

Answer Box: Getting Cosentyx Covered by UnitedHealthcare in Washington Timeline: UnitedHealthcare typically approves Cosentyx prior authorization requests within 3-5 business days for standard cases, with urgent requests processed within 72 hours. Step therapy required: You'll need documented failure of preferred TNF inhibitors like Humira or Enbrel first. Start

How to Get Tegsedi (Inotersen) Covered by UnitedHealthcare in Washington: Complete Prior Authorization Guide

Answer Box: Fast Track to Tegsedi Coverage To get Tegsedi (inotersen) covered by UnitedHealthcare in Washington: 1) Ensure both patient and prescriber are enrolled in the FDA REMS program before submitting prior authorization, 2) Submit complete PA documentation through the UnitedHealthcare Provider Portal including genetic testing, clinical notes, and lab

Work With Your Doctor to Get Lutathera (Lutetium Lu-177 Dotatate) Approved by UnitedHealthcare in Pennsylvania: Complete Provider Collaboration Guide

Quick Answer: Your Path to Lutathera Approval To get Lutathera (lutetium Lu-177 dotatate) covered by UnitedHealthcare in Pennsylvania, you'll need prior authorization showing somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors and documented progression on octreotide or lanreotide. Start today by: (1) requesting your complete medical records from your oncologist, (2)

How to Get Jaypirca (Pirtobrutinib) Covered by UnitedHealthcare in Illinois: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Jaypirca Covered by UnitedHealthcare in Illinois UnitedHealthcare requires prior authorization for Jaypirca (pirtobrutinib) with mandatory step therapy—you must document failure or intolerance to at least one other BTK inhibitor (ibrutinib, acalabrutinib, or zanubrutinib) before approval. For CLL/SLL patients, prior BCL-2 inhibitor failure is also required.

Do You Qualify for Opsumit (Macitentan) Coverage by UnitedHealthcare in Florida? Decision Tree & Next Steps

Quick Answer: Opsumit Coverage by UnitedHealthcare in Florida Most likely eligible if: You have confirmed WHO Group 1 PAH, functional class II-IV symptoms, and a PAH specialist prescriber. Fastest approval path: Have your specialist submit prior authorization through UnitedHealthcare's provider portal with complete hemodynamic data and functional class

Work With Your Doctor to Get Arcalyst (rilonacept) Approved by UnitedHealthcare in Texas: Complete Provider Collaboration Guide

Quick Answer: Your Path to Arcalyst Approval in Texas Getting Arcalyst (rilonacept) approved by UnitedHealthcare requires strong provider collaboration and complete documentation. First step: Schedule a visit to review your diagnosis (CAPS, DIRA, or recurrent pericarditis), document failed treatments (NSAIDs, colchicine), and prepare a medical necessity letter. UnitedHealthcare requires prior

How to Get Dupixent (dupilumab) Covered by UnitedHealthcare in Texas: Complete Guide to Prior Authorization and Appeals

Quick Answer: Getting Dupixent Covered by UnitedHealthcare in Texas Yes, UnitedHealthcare covers Dupixent (dupilumab) in Texas with prior authorization. The fastest path to approval: 1) Have your doctor submit a complete prior authorization request through the UnitedHealthcare provider portal with documented step therapy failures and medical necessity, 2) Include required

How to Get Tysabri (Natalizumab) Covered by UnitedHealthcare in Texas: Complete Appeals Guide with Forms and Templates

Quick Answer: Getting Tysabri Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Tysabri (natalizumab) through OptumRx. You'll need TOUCH enrollment, JCV antibody results, recent MRI, and documentation of failed prior therapies. If denied, you have 180 days to appeal internally, then can request Texas external review

The Requirements Checklist to Get Aldurazyme (laronidase) Covered by UnitedHealthcare in Pennsylvania: Forms, Appeals, and Success Strategies

Answer Box: Getting Aldurazyme Covered by UnitedHealthcare in Pennsylvania Fastest path to approval: Submit prior authorization through the UnitedHealthcare Provider Portal with confirmed MPS I diagnosis (enzymatic + genetic testing), baseline assessments, and specialist attestation. If denied, Pennsylvania's Independent External Review Program has a 50% overturn rate for specialty

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

Answer Box: Getting Isturisa Covered by UnitedHealthcare in New York Eligibility: Adults with Cushing's disease when pituitary surgery isn't an option or hasn't worked. Fastest path: Submit prior authorization through OptumRx with endocrinologist documentation, surgical history, and elevated cortisol labs (UFC, salivary cortisol). First