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HOW TO ENROLL IN ViiVCONNECT
Complete, Sign, and Submit the CABENUVA Enrollment Form
To enroll patients for ViiVConnect, complete and submit the CABENUVA Enrollment Form. Use the ViiVConnect Portal to submit the CABENUVA Enrollment Form or submit a downloadable form if you prefer to fax the enrollment form to ViiVConnect. Fax enrollment forms to 1-844-208-7676.
For guidance, an annotated version of the enrollment form is available to assist you.
For assistance, please call to speak live with an Access Coordinator at 1-844-588-3288 (toll free), or access secure click-to-chat messaging on the ViiVConnect Portal, Monday - Friday, 8AM - 11PM (ET).
Connect to Services and Support
Once the enrollment form has been received, an Access Coordinator may contact you to review patient benefits and program eligibility for prescribed ViiV medicine, offer prior authorization support, and schedule delivery of medication.
Once the enrollment form has been processed, ViiVConnect may contact providers and patients to confirm patient eligibility for ViiVConnect programs and schedule shipment of medication. Providers can choose one of two pathways to obtain medication from ViiV Healthcare: ordering through select specialty pharmacies or ordering through a specialty distributor using the Buy and Bill method.*
Specialty Pharmacies (SPs)
ViiV Healthcare has partnered with several SPs in the US that are experienced with injectable medications and are ready to handle CABENUVA. Practices using SPs will have injectable suspension dosing kits shipped to their office. Patients pay any drug-related copays or coinsurance directly to the SP.
*For patients enrolled in the Patient Assistance Program (PAP), ViiVConnect will schedule shipments of injectable medications and providers will not need to choose an acquisition method.
ViiVConnect provides one-on-one Access Coordinator assistance and resources to help healthcare practices file accurate reimbursement and access claims. Find detailed information in the reimbursement resources below, or connect with an Access Coordinator for answers to questions regarding reimbursement for extended-release injectable suspensions.
HOW TO ENROLL IN ViiVCONNECT
Complete and sign the CABENUVA Enrollment Form with your healthcare provider to connect with an Access Coordinator and see if you are eligible to save on prescribed medication from ViiV Healthcare.
Once you’re enrolled, an Access Coordinator can verify your insurance coverage for prescribed ViiV medicine, determine your eligibility for ViiVConnect programs, and answer any questions you have about getting started with CABENUVA.
A patient signature is required to enroll in ViiVConnect programs. If you are unable to manually sign, use this link to authorize an electronic signature if an enrollment form was submitted previously without one.
Patient Assistance Program
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NEED HELP? TALK ONE-ON-ONE LIVE WITH OUR ACCESS COORDINATORS
1-844-588-3288 (toll free)
We have programs for eligible patients who are insured, underinsured, and uninsured.
Monday - Friday, 8AM - 11PM (ET).
Multilingual options available.