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HARVONI® (ledipasvir 90 mg/sofosbuvir 400 mg) and
EPCLUSA® (sofosbuvir 400 mg/velpatasvir 100 mg)
full Prescribing Information, including BOXED WARNING.

Forms and resources to help patients start on therapy and move toward treatment completion

  • Support Path Intake Form

    Use this form to initiate benefits investigation, get prior authorization support, or enroll a patient into the Support Path program.

    Click here for the Intake Form
  • Sample Summary of Benefits form

    Once your patient is enrolled, the Support Path team will conduct a benefits investigation and you will receive results like in the sample below.

    Sample Summary of Benefits form
  • Sample Letter of Medical Necessity

    Some insurance providers may require you to submit a Letter of Medical Necessity to help patients begin treatment. This template highlights important information that may be included.

    Sample Letter of Medical Necessity
  • Appeals Tips and Checklist

    This document can help you put together an appeals package for your patient.

    Appeals Tips and Checklist
  • Understanding Your Patient's Medication Coverage

    Before you call Support Path to verify your patient's medication coverage you will need to have certain information on hand. This cheat sheet can help guide you through the process.

    Understanding Your Patient's Medication Coverage
  • Diagnosis, Screening, and Procedure Codes

    Use these downloadable reference sheets to find commonly used ICD-10 and CPT codes.

    ICD-10 codes   CPT codes
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