Patient Enrollment


What can you do with enrollment?
Enroll patients in ViiVConnect to work with an Access Coordinator on benefit verification and savings and assistance programs* that may help patients access their prescribed ViiV Healthcare medications.
Subject to eligibility, program terms, and conditions. ViiVConnect programs do not constitute health insurance.
Enroll by Fax or Mail
Follow the instructions on the downloadable enrollment form to submit by fax or mail. The editable form can be filled in online or printed to fill in by hand.
Enroll Online
Enroll patients digitally through the Provider Portal.
In addition to submitting electronic enrollment forms on the Provider Portal, you can also:
- Upload documents
- Check patient enrollment status
- See patient coverage information
- Receive email notifications
- View product shipment information
- Chat with an Access Coordinator
Prescription Claims
Sample Letter of Medical Necessity
Download our Sample Letter of Medical Necessity to see the format and types of information needed for timely prescription claim approvals.
Prior Authorization (PA) Support
Review our PA checklists or speak with an Access Coordinator for guidance on how to help minimize delays and denials of prescribed ViiV Healthcare medications.
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