Regence · Prior auth
Regence prior authorization criteria
Submission criteria, documentation packets, and P2P prep by drug — for prescribers and PA staff. 30-day standard PA decision.
Standard PA decision
30 days
Appeal window if denied
180 days
Drugs covered
62
Regence reviews prior-authorization requests against its published medical policies — diagnosis with ICD-10 code, documented step-therapy history, and prescriber attestation of medical necessity. Standard PA decisions return in 30 days; if denied, prescribers and members have 180 days to appeal. Criteria by drug below.
Prior authorization criteria by drug
Each page covers Regence's submission criteria, the documentation packet, and peer-to-peer prep for that drug.
- Adalimumab at Regence →
- Aflibercept at Regence →
- Apixaban at Regence →
- Atezolizumab at Regence →
- Atogepant at Regence →
- Benralizumab at Regence →
- Bevacizumab at Regence →
- Bictegravir at Regence →
- Buprenorphine at Regence →
- Dapagliflozin at Regence →
- Dulaglutide at Regence →
- Dupilumab at Regence →
- Eculizumab at Regence →
- Elexacaftor Tezacaftor Ivacaftor at Regence →
- Empagliflozin at Regence →
- Erenumab at Regence →
- Evolocumab at Regence →
- Faricimab at Regence →
- Fingolimod at Regence →
- Fremanezumab at Regence →
- Galcanezumab at Regence →
- Glecaprevir Pibrentasvir at Regence →
- Guselkumab at Regence →
- Ibrutinib at Regence →
- Imatinib at Regence →
- Inclisiran at Regence →
- Infliximab at Regence →
- Ixekizumab at Regence →
- Lenalidomide at Regence →
- Liraglutide at Regence →
- Lisdexamfetamine at Regence →
- Mepolizumab at Regence →
- Methylphenidate at Regence →
- Naltrexone at Regence →
- Natalizumab at Regence →
- Nintedanib at Regence →
- Nivolumab at Regence →
- Nusinersen at Regence →
- Ocrelizumab at Regence →
- Ofatumumab at Regence →
- Omalizumab at Regence →
- Ozanimod at Regence →
- Palbociclib at Regence →
- Pembrolizumab at Regence →
- Pirfenidone at Regence →
- Ribociclib at Regence →
- Rimegepant at Regence →
- Risankizumab at Regence →
- Rituximab at Regence →
- Rivaroxaban at Regence →
- Sacubitril Valsartan at Regence →
- Secukinumab at Regence →
- Semaglutide at Regence →
- Sofosbuvir at Regence →
- Tafamidis at Regence →
- Tenofovir Alafenamide at Regence →
- Tezepelumab at Regence →
- Tirzepatide at Regence →
- Tofacitinib at Regence →
- Trastuzumab at Regence →
- Upadacitinib at Regence →
- Ustekinumab at Regence →
Generate a Regence PA packet
Open ApprovalHelp — generate a prior-auth packet tailored to Regence's criteria, with prescriber attestation and step-therapy documentation pre-filled.
Get started →Contact: hello@approvalhelp.com