New! Enroll your patients through the online enrollment portal today!

ENROLL ONLINE

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OR ENROLL BY FAX

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Appeals process resources

If a PA is denied, you can use these templates during the appeals process. Takeda Patient Support can also answer questions your office has about the denials and appeals process.

Formulary Exception Letter

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Letter of Intent to Treat

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Statement of Medical Necessity

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Claim Denial Letter

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Coverage Denial Letter

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EMAIL

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Takeda Patient Support—support specialists your patient can count on

When you prescribe a Takeda treatment for your patient, Takeda Patient Support is here for them.

Enroll your patient

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References: 1. Takhzyro. Prescribing information. Dyax Corp; 2023. 2. Wang Y, Marier JF, Kassir N, Chang C, Martin P. Clin Transl Sci. 2020;13(6):1208-1216. doi:10.1111/cts.12806

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