Topic

Texas

A collection of 386 issues

How to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in Texas: Appeals Process, Forms, and Approval Scripts

Answer Box: Getting Firdapse Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Firdapse (amifampridine) in Texas with no step therapy requirement. Submit via the UHC Provider Portal with confirmed LEMS diagnosis (P/Q-type VGCC antibodies + EMG showing ≥60% CMAP increment), neurologist prescription, and no seizure history. Standard approval
5 min read

How to Get Besponsa (Inotuzumab Ozogamicin) Covered by Cigna in Texas: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Besponsa Covered by Cigna in Texas Cigna requires prior authorization for Besponsa (inotuzumab ozogamicin) with CD22-positive B-cell precursor ALL documentation. Submit the Cigna Besponsa CCRD PA form with pathology confirming CD22 status, relapsed/refractory disease history, and medical necessity letter. If denied, file internal appeal within 180
6 min read

Do You Qualify for Luxturna (Voretigene Neparvovec-rzyl) Coverage by Blue Cross Blue Shield in Texas? Decision Tree & Appeals Guide

Answer Box: Getting Luxturna Covered in Texas Yes, Luxturna (voretigene neparvovec-rzyl) can be covered by Blue Cross Blue Shield of Texas for patients with confirmed biallelic RPE65 mutations and sufficient retinal viability. The fastest path: (1) Confirm genetic testing shows biallelic RPE65 pathogenic variants, (2) Submit prior authorization through BCBSTX
5 min read