Topic

Virginia

A collection of 238 issues

How Long Does It Take to Get Firazyr (icatibant) Approved by UnitedHealthcare in Virginia? Complete Timeline & Appeals Guide

Answer Box: Getting Firazyr Approved by UnitedHealthcare in Virginia Timeline: Standard prior authorization takes 1-7 days; expedited reviews within 72 hours for urgent cases. Requirements: Confirmed HAE diagnosis, specialist prescription (immunologist/allergist), documentation of prior therapy failures, and self-administration training records. First step: Have your HAE specialist submit a complete
5 min read

Blue Cross Blue Shield Virginia's Coverage Criteria for Berinert (C1-Esterase Inhibitor): What Counts as "Medically Necessary"?

Answer Box: Getting Berinert Covered in Virginia Blue Cross Blue Shield Virginia requires prior authorization for Berinert with specific medical necessity criteria: confirmed HAE diagnosis, specialist involvement, and documentation of attack frequency. Fastest path: Have your allergist/immunologist submit PA with C1-INH lab values, attack history, and failed first-line treatments.
6 min read

How to Get Isturisa (Osilodrostat) Covered by UnitedHealthcare in Virginia: Complete Timeline & Appeals Guide

Answer Box: Getting Isturisa Covered by UnitedHealthcare in Virginia UnitedHealthcare requires prior authorization for Isturisa (osilodrostat) in Virginia, with decisions typically taking 1-5 business days for complete submissions. The fastest path: (1) Have your endocrinologist gather complete diagnostic labs (UFC, salivary cortisol, DST), surgical history, and medical necessity documentation, (2)
6 min read

How to Get Tremfya (Guselkumab) Covered by Blue Cross Blue Shield Virginia: Prior Authorization Forms, Appeals, and Step-by-Step Guide

Answer Box: Getting Tremfya (Guselkumab) Covered by Blue Cross Blue Shield Virginia Tremfya (guselkumab) requires prior authorization from Blue Cross Blue Shield Virginia (Anthem). The fastest path to approval involves three steps: 1) Submit complete prior authorization documentation including PASI scores and failed therapy history through Anthem's Availity
6 min read

How to Get Therakos CELLEX Photopheresis Covered by UnitedHealthcare in Virginia: Complete Appeal Guide with Forms and Timelines

Quick Answer: Getting UnitedHealthcare to Cover Therakos CELLEX in Virginia UnitedHealthcare requires prior authorization for Therakos CELLEX photopheresis, but coverage is provided when medical necessity criteria are met for conditions like steroid-refractory GVHD and advanced CTCL. The fastest path to approval: (1) Submit PA request through UHC provider portal with
6 min read

How to Get Naglazyme (galsulfase) Covered by Blue Cross Blue Shield in Virginia: Complete Prior Authorization Guide

Answer Box: Getting Naglazyme Covered by Blue Cross Blue Shield in Virginia Blue Cross Blue Shield Virginia requires prior authorization for Naglazyme (galsulfase), with coverage based on confirmed MPS VI diagnosis, documented functional impairment, and objective outcome measures. The fastest path to approval involves submitting comprehensive documentation through Anthem'
6 min read

How to Get Darzalex / Darzalex Faspro (daratumumab) Covered by Aetna (CVS Health) in Virginia: Complete Guide to Prior Authorization, Appeals, and State Protections

Answer Box: Your Fastest Path to Coverage Getting Darzalex / Darzalex Faspro (daratumumab) covered by Aetna (CVS Health) in Virginia requires prior authorization and often step therapy compliance. Your oncologist must document that bortezomib (the preferred agent) has failed or is contraindicated. Submit Aetna's precertification form via phone (1-866-752-7021)
6 min read

Work With Your Doctor to Get Keppra (Levetiracetam) Approved by UnitedHealthcare in Virginia: Complete Provider Collaboration Guide

Answer Box: Getting Keppra Covered by UnitedHealthcare in Virginia Generic levetiracetam typically requires no prior authorization from UnitedHealthcare, but brand-name Keppra often does. The fastest path to approval: 1) Ask your doctor to prescribe generic levetiracetam first (usually covered), 2) If brand Keppra is medically necessary, document a 4-week generic
6 min read