Topic

Washington

A collection of 233 issues

How to Get Signifor LAR (Pasireotide) Covered by Humana in Washington: Appeals Guide with Forms and Timelines

Answer Box: Getting Signifor LAR Covered by Humana in Washington Humana requires prior authorization for Signifor LAR (pasireotide) in 2024. For Cushing's disease or acromegaly patients in Washington, the fastest path to approval involves: (1) Your endocrinologist submitting a complete prior authorization request through Humana's provider

How to Get Dojolvi (Triheptanoin) Covered by Blue Cross Blue Shield in Washington: Forms, Appeals, and Provider Resources

Quick Start: Getting Dojolvi Covered by Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington (Premera Blue Cross, Regence BlueShield) require prior authorization for Dojolvi (triheptanoin) with molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD). The fastest path: (1) Gather genetic test results confirming LC-FAOD

Do You Qualify for Tecentriq Coverage by Blue Cross Blue Shield in Washington? Decision Tree & Next Steps

Answer Box: Getting Tecentriq Covered by Blue Cross Blue Shield in Washington Yes, Blue Cross Blue Shield plans in Washington cover Tecentriq (atezolizumab) for FDA-approved indications, but prior authorization is required. Most approvals happen within 72 hours when you submit complete documentation. Your first step: Have your oncologist gather your

Getting Pomalyst (Pomalidomide) Approved by Humana in Washington: Complete Prior Authorization and Appeals Guide

How to Get Pomalyst Approved by Humana in Washington Quick Answer: Humana requires prior authorization for Pomalyst (pomalidomide) with documented failure of both lenalidomide and a proteasome inhibitor, plus REMS program enrollment. Submit through your oncologist with complete therapy history. If denied, use Humana's internal appeals process first—

How to Get Cresemba (Isavuconazole) Covered by Humana in Washington: Complete Forms, Appeals & Portal Guide

Quick Start: Getting Cresemba Covered by Humana in Washington Cresemba (isavuconazole) requires prior authorization from Humana and must be filled through their specialty pharmacy network. Most approvals happen within 7 days when you submit complete clinical documentation showing invasive aspergillosis or mucormycosis diagnosis, plus evidence that voriconazole failed or can&

Getting Helixate (Factor VIII) Covered by Humana in Washington: Prior Authorization Guide and Appeal Process

Quick Answer: Getting Helixate Covered by Humana in Washington Helixate (recombinant Factor VIII) requires prior authorization from Humana and may face formulary challenges since related products like Kogenate FS were discontinued in the US. Your fastest path to approval: (1) Have your hematologist submit a complete prior authorization request with

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

How to Get Voydeya (Danicopan) Covered by Humana in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Voydeya (Danicopan) Covered by Humana in Washington Humana requires prior authorization for Voydeya (danicopan) for PNH treatment. The fastest path to approval: (1) Ensure your hematologist submits a complete prior authorization with PNH diagnosis by flow cytometry, documentation of extravascular hemolysis despite optimized C5 inhibitor therapy, and

Getting Breyanzi (Lisocabtagene Maraleucel) Covered by Aetna CVS Health in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Breyanzi (lisocabtagene maraleucel) requires prior authorization from Aetna CVS Health for all plan types. Submit complete documentation via Availity portal or fax 1-877-269-9916. If denied, file internal appeal within 180 days, then request external review through Washington's Office of Insurance Commissioner within 4 months. Success depends