Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1141 issues

Get Crysvita (Burosumab) Covered by UnitedHealthcare in Georgia: Complete Guide with Forms, Appeals, and Contacts

Answer Box: Getting Crysvita Covered by UnitedHealthcare in Georgia Fastest path to approval: Submit a prior authorization through UnitedHealthcare's provider portal with genetic testing or elevated FGF23 results, specialist prescription, and documented low serum phosphorus. Adults need proof of failed oral phosphate plus calcitriol therapy first. If denied,

How to Get Trikafta Covered by UnitedHealthcare in New York: Prior Authorization, Appeals & Specialty Pharmacy Guide

Answer Box: Getting Trikafta Covered by UnitedHealthcare in New York Trikafta requires prior authorization from UnitedHealthcare and must be filled through an approved specialty pharmacy like Optum Specialty Pharmacy. The drug is placed on Tier 3 (specialty tier) with the highest cost-sharing. To get approved: (1) Your doctor submits a

How Long Does It Take to Get Lamzede (velmanase alfa-tycv) Approved by UnitedHealthcare in Georgia? Complete Timeline Guide

Answer Box: Getting Lamzede Approved by UnitedHealthcare in Georgia Timeline: UnitedHealthcare must respond to Lamzede (velmanase alfa-tycv) prior authorization requests within 7 calendar days for standard reviews, 2 business days for urgent cases. Key requirements: confirmed alpha-mannosidosis diagnosis (enzyme assay or MAN2B1 mutation), non-CNS manifestations, and specialist documentation. First step:

If Nourianz (Istradefylline) Isn't Approved by UnitedHealthcare in California: Formulary Alternatives & Exception Paths

Answer Box: Nourianz Alternatives & Exception Paths If UnitedHealthcare denies Nourianz (istradefylline) in California, you'll typically need to try formulary alternatives first through step therapy. Preferred options include amantadine, MAO-B inhibitors (rasagiline/selegiline), or COMT inhibitors (entacapone/tolcapone). Document treatment failures or contraindications carefully—this evidence becomes crucial

If Soliris Isn't Approved by UnitedHealthcare in Florida: Formulary Alternatives & Exception Paths

Answer Box: Your Options When UnitedHealthcare Denies Soliris in Florida If UnitedHealthcare denies Soliris (eculizumab) in Florida, you have two main paths: try a covered alternative like Ultomiris (ravulizumab) or request a formulary exception with strong medical necessity documentation. UnitedHealthcare typically requires step therapy with alternatives before approving Soliris. Start

Renewing Rinvoq (Upadacitinib) Approval with UnitedHealthcare in New Jersey: Timeline, Documentation & Appeal Options

Answer Box: Renewing Rinvoq with UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization renewal for Rinvoq every 12 months. Start the renewal process 30-45 days before expiration to avoid treatment gaps. You'll need documentation of clinical response, current lab values, and confirmation you're not using contraindicated

Complete Guide: Getting Lumizyme (Alglucosidase Alfa) Covered by UnitedHealthcare in Texas - ICD-10 Codes, HCPCS Billing, and Appeals Process

Quick Answer: Getting Lumizyme Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Lumizyme (alglucosidase alfa) in Texas. The fastest path to approval requires: (1) confirmed Pompe disease diagnosis with ICD-10 code E74.02, (2) genetic testing or enzyme assay documentation, and (3) medical necessity letter from a specialist.

How to Get Uptravi (Selexipag) Covered by UnitedHealthcare in Ohio: Complete Guide with Forms, Appeals & Contact Info

Answer Box: Getting Uptravi Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Uptravi (selexipag) in Ohio through OptumRx. The fastest path to approval: (1) Submit PA request via the UnitedHealthcare Provider Portal with complete PAH documentation, (2) Include WHO Group I PAH diagnosis, functional class, and prior therapy

Work With Your Doctor to Get Zokinvy (lonafarnib) Approved by UnitedHealthcare in New Jersey: Complete Provider Collaboration Guide

Answer Box: Getting Zokinvy Approved Through Provider Partnership To get Zokinvy (lonafarnib) covered by UnitedHealthcare in New Jersey: Work with your doctor to submit prior authorization with genetic confirmation of HGPS, specialist consultation notes, and BSA-based dosing justification. If denied, you have 180 days for internal appeals, then 4 months

Getting iLink® Corneal Cross-Linking Covered by UnitedHealthcare in North Carolina: Complete Appeals Guide

Quick Answer: Your Path to Coverage UnitedHealthcare commercial plans in North Carolina cover iLink® corneal cross-linking for progressive keratoconus when medical necessity criteria are met. Start with a prior authorization request through your ophthalmologist, including corneal topography showing progression and documentation of failed conservative treatments. If denied, you have 180