Topic

Xyrem (sodium oxybate)

A collection of 23 issues

How to Get Xyrem (Sodium Oxybate) Covered by Humana in Illinois: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Xyrem Covered by Humana in Illinois Xyrem (sodium oxybate) requires prior authorization from Humana and mandatory REMS enrollment before coverage. In Illinois, you have 65 days to appeal denials, followed by external review through the Illinois Department of Insurance if needed. Fastest path to approval: 1. Complete

Myths vs. Facts: Getting Xyrem (Sodium Oxybate) Covered by Blue Cross Blue Shield in Washington

Answer Box: Getting Xyrem Covered by Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington (Premera, Regence/UMP) almost always require prior authorization for Xyrem (sodium oxybate) for narcolepsy. Success depends on complete REMS enrollment, documented narcolepsy diagnosis with sleep studies, and proof of failed stimulant

Xyrem (Sodium Oxybate) Approval with UnitedHealthcare in Georgia: Answers to the Most Common Questions

Answer Box: Getting Xyrem Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Xyrem (sodium oxybate) in Georgia, with strict step-therapy requirements including trials of modafinil, armodafinil, and other wake-promoting agents. The fastest path: (1) Complete REMS enrollment at XywavXyremREMS.com, (2) Submit PA via UnitedHealthcare provider portal with

Getting Xyrem (Sodium Oxybate) Covered by Cigna in Washington: Complete Prior Authorization Guide

Answer Box: Getting Xyrem Covered by Cigna in Washington Eligibility: Cigna requires prior authorization for Xyrem (sodium oxybate) with documented narcolepsy, sleep study results, and failed stimulant therapy. Fastest path: Have your sleep specialist complete Cigna's PA form with PSG/MSLT results and dextroamphetamine trial documentation. Start today:

How to Get Xyrem (Sodium Oxybate) Covered by Cigna in Illinois: Prior Authorization Guide and Appeals Process

Answer Box: Getting Xyrem Covered by Cigna in Illinois Fastest path to approval: Cigna requires prior authorization for Xyrem (sodium oxybate) with documented narcolepsy diagnosis, sleep study results, and failed trials of first-line treatments. Submit the Cigna Xyrem PA form with complete clinical documentation. If denied, you have 180 days

How Long Does It Take to Get Xyrem (Sodium Oxybate) Approved by UnitedHealthcare in North Carolina? Complete Timeline & Appeals Guide

Quick Answer: Xyrem Approval Timeline in North Carolina Getting Xyrem (sodium oxybate) approved by UnitedHealthcare in North Carolina typically takes 1-15 business days for the prior authorization decision, plus 1-3 days for REMS enrollment. The fastest path: ensure both you and your prescriber complete REMS enrollment first, then have your

How to Get Xyrem (Sodium Oxybate) Covered by Cigna in Georgia: Complete Coding and Appeals Guide

Answer Box: Getting Xyrem Covered by Cigna in Georgia To get Xyrem (sodium oxybate) covered by Cigna in Georgia, you need proper diagnosis codes (G47.411 for narcolepsy with cataplexy), HCPCS J-code J8499, and enrollment in the Xyrem REMS program. Submit prior authorization through Cigna's provider portal or

How to Get Xyrem (Sodium Oxybate) Covered by Blue Cross Blue Shield in Pennsylvania: Complete 2024 Guide with Forms and Appeals

Answer Box: Getting Xyrem Covered by Blue Cross Blue Shield in Pennsylvania Xyrem requires prior authorization from all Blue Cross Blue Shield plans in Pennsylvania. The fastest path to approval: (1) Ensure both patient and prescriber are enrolled in the REMS program, (2) Submit PA through your plan's

How to Get Xyrem (Sodium Oxybate) Covered by Aetna (CVS Health) in California: Complete 2025 Guide

Quick Answer: Getting Xyrem Covered by Aetna (CVS Health) in California Yes, Aetna covers Xyrem with prior authorization. You'll need REMS enrollment first, then submit PA with sleep study results and documented stimulant/modafinil failures. Standard approval takes 15 business days. If denied, California's Independent Medical

How Long Does It Take to Get Xyrem Approved by UnitedHealthcare in Illinois? Complete Timeline & Approval Milestones

Answer Box: Xyrem Approval Timeline with UnitedHealthcare in Illinois Getting Xyrem (sodium oxybate) approved by UnitedHealthcare in Illinois typically takes 72 hours to 15 days, depending on documentation completeness and clinical urgency. Both patient and prescriber must complete REMS enrollment first (1-3 business days). UnitedHealthcare requires prior authorization with evidence