Topic

Tepezza (teprotumumab)

A collection of 26 issues

How to Get Tepezza (teprotumumab) Covered by Humana in Georgia: Complete Prior Authorization and Appeals Guide

Quick Answer: Humana requires prior authorization for Tepezza (teprotumumab) for thyroid eye disease in Georgia. Submit your PA request through CoverMyMeds or Humana's provider portal with complete TED documentation: CAS score ≥4, thyroid labs within 30 days, prior therapy history, and ophthalmology notes. If denied, appeal within 65

Renewing Tepezza (Teprotumumab) Approval with Aetna CVS Health in New York: Complete Guide to Documentation and Timelines

Answer Box: Renewing Tepezza Coverage Most Aetna CVS Health plans limit Tepezza to one 8-infusion course per lifetime. Renewal beyond 8 doses requires exceptional documentation showing unmet clinical need plus peer-reviewed evidence supporting extended treatment. Start renewal requests 2-4 weeks before your final scheduled infusion. If denied, New York residents

How to Get Tepezza (Teprotumumab) Covered by Cigna in Virginia: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Tepezza Approved by Cigna in Virginia Cigna requires prior authorization for Tepezza (teprotumumab) in Virginia. Your fastest path: Have your ophthalmologist or endocrinologist submit a PA request with documented moderate-to-severe thyroid eye disease (TED), including objective measurements and functional impact. If denied, you have 180 days to

How to Get Tepezza (Teprotumumab) Covered by UnitedHealthcare in Illinois: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tepezza Covered by UnitedHealthcare in Illinois UnitedHealthcare requires prior authorization for Tepezza (teprotumumab, HCPCS J3241) under the medical benefit. To get approval: 1) Submit PA via UHC Provider Portal with thyroid eye disease diagnosis, Clinical Activity Score ≥3, recent thyroid labs, and documented steroid trial/contraindication. 2)

How to Get Tepezza (Teprotumumab) Covered by Cigna in Georgia: Complete Prior Authorization Guide

Answer Box: Getting Tepezza Covered by Cigna in Georgia Cigna requires prior authorization for Tepezza (teprotumumab) in Georgia, with approval based on moderate-to-severe thyroid eye disease (TED) criteria. Standard review takes 5 business days; urgent cases can be expedited within 24-72 hours. If denied, you have 180 days to appeal

Complete Guide to Getting Tepezza (Teprotumumab) Covered by Blue Cross Blue Shield in Pennsylvania: Prior Authorization, Appeals, and Success Strategies

Answer Box: Quick Path to Tepezza Coverage To get Tepezza (teprotumumab) covered by Blue Cross Blue Shield in Pennsylvania, you need prior authorization showing moderate-to-severe thyroid eye disease (Clinical Activity Score ≥3), euthyroid status, and either failed corticosteroid treatment or documented contraindication. Submit through your provider portal or fax to

Lowering Out-of-Pocket Costs for Tepezza (teprotumumab) with Blue Cross Blue Shield in California: Copay Cards, Appeals, and Financial Assistance

Answer Box: Getting Tepezza Covered at Lower Cost Blue Cross Blue Shield California requires prior authorization for Tepezza (teprotumumab), but multiple cost-reduction strategies can help. The medication must be prescribed by an endocrinologist or ophthalmologist, with documented thyroid levels within 50% of normal limits. Fastest path: 1) Apply for Amgen&

How to Get Tepezza (Teprotumumab) Covered by Aetna CVS Health in Illinois: Prior Authorization Forms, Appeals Process, and Alternative Options

Quick Answer: Getting Tepezza Covered by Aetna CVS Health in Illinois Tepezza (teprotumumab) requires prior authorization from Aetna CVS Health in Illinois. You'll need documentation of moderate-to-severe thyroid eye disease, failure or contraindication to corticosteroids, and ophthalmology consultation. If denied, Illinois law provides strong appeal rights including independent

Get Tepezza (Teprotumumab) Covered by UnitedHealthcare in North Carolina: Forms, Appeals & Step-by-Step Guide

Answer Box: Your Fastest Path to Approval To get Tepezza (teprotumumab) covered by UnitedHealthcare in North Carolina, you need prior authorization with specific clinical documentation. Submit your PA request through the UnitedHealthcare Provider Portal or use the North Carolina-specific pharmacy prior authorization form. Required: moderate-to-severe thyroid eye disease diagnosis by

How to Get Tepezza (teprotumumab) Covered by Cigna in Washington: Prior Authorization, Appeals, and Billing Guide

Quick Answer: Tepezza (teprotumumab) requires prior authorization through Cigna's Express Scripts/Accredo specialty pharmacy network. Submit clinical documentation including TED diagnosis (ICD-10: E05.00), disease severity assessment, and weight-based dosing justification. If denied, Washington residents can appeal through internal review, then external IRO review within 60 days. Start