INJECTABLES
Implementation Education Center
Click on a key step below for tips and resources at each stage of the journey:
Prepare your practice by considering:
Storage and handling requirements
- Consider where the ViiV Injectable will be stored. For example, refrigeration may be required
- Determine how the product will be tracked and received
Access and acquisition
- Familiarize your team with prescribing pathways
- Establish a benefits verification process (enrolling in ViiVConnect may help)
Office staff education
- Ensure qualified staff are confident administering a ViiV Injectable
- For assistance, request injection education here
Billing and reimbursement
- Check payer contracts and determine if the provider is in-network
- Ensure you are correctly coding and submitting claims
- Refer to the injectable product's Access and Reimbursement Guide for detailed information
Determine how your practice will conduct a patient's benefit verification
Through ViiVConnect
Enrolling in ViiVConnect provides you with access and acquisition services for ViiV Injectables, including:
- Conducting a benefits verification
- Assistance in navigating product acquisition
Independently managed
For practices that prefer to manage the acquisition and administration of ViiV Injectables on their own:
- This option allows your office to conduct a benefits verification and navigate product acquisition
Consider RealTime Benefit Verification to check a patient’s benefit and coverage information. Learn more about RealTime BV here or visit the HCP Portal to access this tool.
Benefits verification results should include:
- Predetermination
- Acquisition pathway information
- Prior Authorization (PA) requirement(s)
Factors that can affect access and reimbursement:
Type of payer
Understanding each patient’s unique insurance is essential to helping them get their medication. Your patient may have coverage under one of the following payers:
- Private or commercial insurance
- Medicaid and/or Medicare
Acquisition pathway
An insurance plan may cover ViiV Injectables under the medical benefit, pharmacy benefit, or both. This information is confirmed during the benefits verification process, which helps determine how your patient’s ViiV Injectable will be acquired and reimbursed
Place of service
Insurance coverage of medications may vary depending on where the product is administered. Locations include:
- Your office
- A hospital outpatient facility
- An independent clinic
- An Alternative Site of Care (ASOC), such as an infusion clinic
Access and Reimbursement Guides
Prior Authorization (PA) resources
Pursue the acquisition pathway specified in the patient's Summary of Benefits
If your patient’s insurance covers a ViiV Injectable under the pharmacy benefit, you may acquire the product through a specialty pharmacy.
If your patient’s insurance covers a ViiV Injectable under the medical benefit, you may acquire the product directly from a specialty distributor, also known as “Buy and Bill.”
If you prefer to have an Alternative Site of Care (ASOC) acquire and administer your patient’s injection(s), please visit the ASOC Locator page for more information.
Choose where your patient will receive their injection
In-office administration
Injection instructions can be found on the product sites below:
Request Injection Education
If you would like additional injection education, click the link below.
Alternative Site of Care (ASOC) administration
ASOCs present you with the ability to prescribe ViiV Injectables without having to acquire and administer the medication in your office. See below for more information on working with an ASOC or complete the fields below to find a convenient facility.
Billing and reimbursement steps are based on how your office acquired the ViiV Injectable
If the ViiV Injectable was acquired through the pharmacy benefit:
- Submit claims to your patient’s insurance company for the office visit and the administration of the ViiV Injectable
- If applicable, collect the copay from the patient for the office visit
- If the patient is enrolled in the ViiVConnect Patient Savings Program, submit the Explanation of Benefits (EOB) to ViiVClaims.com for reimbursement of the administration fee
If the ViiV Injectable was acquired through the medical benefit (Buy and Bill):
- Once administered, your practice will bill the patient’s insurance for product reimbursement and administration services. Your practice is also responsible for collecting any copays or coinsurance for the product
- After receiving payer reimbursement, if the patient is enrolled in the ViiVConnect Patient Savings Program, submit the EOB to ViiVClaims.com for reimbursement of the product copay and administration fee.