Topic

Washington

A collection of 489 issues

How Long Does It Take to Get Elelyso (taliglucerase alfa) Approved by Cigna in Washington? Complete Timeline Guide

Answer Box: Getting Elelyso Approved by Cigna in Washington Cigna typically decides on Elelyso (taliglucerase alfa) prior authorization requests within 1-3 business days when submitted electronically with complete documentation. Washington state requires insurers to respond within 3 calendar days for standard requests. Your fastest path: (1) Ensure your specialist has

How to Get Signifor / Signifor LAR (pasireotide) Approved by Cigna in Washington: Complete Timeline and Appeals Guide

Quick Answer: Getting Signifor Approved by Cigna in Washington Cigna requires prior authorization for Signifor/Signifor LAR (pasireotide) with 72-hour standard review times in Washington. Your endocrinologist must submit clinical documentation proving medical necessity, including biochemical evidence (elevated UFC for Cushing's or IGF-1 for acromegaly) and justification why

Renewing Carbaglu (Carglumic Acid) Coverage with Cigna in Washington: Complete Timeline and Documentation Guide

Answer Box: Renewing Carbaglu Coverage with Cigna in Washington Renewal Trigger: Start 2-4 weeks before your current authorization expires. Required Documentation: Updated plasma ammonia levels, weight documentation, and specialist letter confirming ongoing medical necessity for NAGS deficiency treatment. First Step: Contact Accredo at 877-826-7657 to check your renewal date and

How to Get Retevmo (Selpercatinib) Covered by Aetna in Washington: Prior Authorization Guide and Appeal Scripts

Answer Box: Getting Retevmo Covered by Aetna in Washington Aetna requires prior authorization for Retevmo (selpercatinib), with documentation of RET fusion testing and step therapy compliance. Most approvals take 72 hours with complete documentation. If denied, you have 60 days to appeal internally, then can request external review through Washington&

Coding That Helps Get Eloctate Covered by UnitedHealthcare in Washington (ICD-10, HCPCS/J-Code, NDC Guide)

Answer Box: Getting Eloctate Coded Correctly for UnitedHealthcare Coverage in Washington Quick Path to Approval: Use ICD-10 code D66 for hemophilia A, HCPCS J7205 for billing, and match the exact NDC to your vial strength. UnitedHealthcare requires prior authorization with hematologist prescription and stays within 40,250 units per 30-day

Emgality Approval with UnitedHealthcare in Washington: Complete Guide to Prior Authorization, Appeals, and Coverage

Answer Box: Getting Emgality Covered by UnitedHealthcare in Washington UnitedHealthcare covers Emgality (galcanezumab) in Washington with prior authorization. You'll need documentation of migraine diagnosis, at least 4 migraine days per month, and failed trials of 2+ preventive medications. Submit through the UnitedHealthcare Provider Portal with complete clinical records.

If Adynovate Isn't Approved by Aetna CVS Health in Washington: Formulary Alternatives & Exception Paths

Answer Box: Getting Adynovate Covered in Washington If Aetna CVS Health denies Adynovate (bdanocog alfa pegol) in Washington, you have three paths: 1) Try a preferred formulary alternative like Eloctate or Kovaltry first (fastest approval), 2) Request a formulary exception with documented medical necessity, or 3) Appeal the denial through

How to Get Vyondys 53 (Golodirsen) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Cigna requires prior authorization for Vyondys 53 (golodirsen) with genetic testing confirming exon 53-skippable DMD mutation, specialist prescription, baseline kidney function tests, and 6+ months of steroid stabilization. Submit through Express Scripts specialty pharmacy portal. If denied, Washington residents have 180 days for internal appeals, then external review

Work With Your Doctor to Get Keytruda (pembrolizumab) Approved by Blue Cross Blue Shield in Washington: Provider Collaboration Guide

Answer Box: Getting Keytruda Approved in Washington Keytruda (pembrolizumab) requires prior authorization from Blue Cross Blue Shield plans in Washington, including Premera and Regence. Your oncologist must submit clinical documentation proving medical necessity, including PD-L1 testing results for certain cancers and evidence of appropriate diagnosis staging. The fastest path: schedule

Get Rystiggo (Rozanolixizumab-noli) Covered by Aetna in Washington: Coding, Appeals & IRO Guide

Answer Box: Quick Path to Rystiggo Coverage To get Rystiggo (rozanolixizumab-noli) covered by Aetna in Washington, you need proper coding and documentation. Use ICD-10 G70.00 or G70.01 for myasthenia gravis, J-code J9333 for billing, and ensure antibody test results (AChR+ or MuSK+) are documented. If denied, Washington offers