Form 1347 Emflaza Authorization Request (Medicaid) - Texas

What Is Form 1347?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 1347 Emflaza Authorization Request?
A: Form 1347 Emflaza Authorization Request is a document used to request Medicaid coverage for the medication Emflaza in the state of Texas.

Q: What is Emflaza?
A: Emflaza is a medication used to treat Duchenne muscular dystrophy.

Q: Who can use Form 1347 Emflaza Authorization Request?
A: This form is for individuals who are eligible for Medicaid and need Medicaid coverage for Emflaza.

Q: What does Form 1347 Emflaza Authorization Request require?
A: The form requires information about the patient, their Medicaid eligibility, and the medical necessity for Emflaza.

Q: How long does it take to process Form 1347 Emflaza Authorization Request?
A: The processing time can vary, but it typically takes a few weeks to receive a decision on Medicaid coverage for Emflaza.

Q: Is there a cost for submitting Form 1347 Emflaza Authorization Request?
A: There is no cost for submitting the form, but Medicaid coverage for Emflaza may have certain cost-sharing requirements.

Q: Can I appeal if my Form 1347 Emflaza Authorization Request is denied?
A: Yes, if your request for Medicaid coverage for Emflaza is denied, you have the right to appeal the decision.

Q: Who can I contact for more information about Form 1347 Emflaza Authorization Request?
A: You can contact your local Medicaid office or the Texas Medicaid program for more information about the form and the Medicaid coverage for Emflaza.