Hepatitis C Antiviral Therapy Prior Authorization Request

Streamline Hepatitis C Treatment Approvals with Paperform

Hepatitis C antiviral therapy requires thorough prior authorization documentation to ensure patients receive timely treatment. This Hepatitis C Antiviral Therapy Prior Authorization Request template simplifies the complex approval process for hepatology practices, infectious disease clinics, and healthcare administrators managing insurance submissions.

Why This Template Works for Healthcare Providers

Prior authorization for direct-acting antivirals (DAAs) involves multiple clinical data points—viral load measurements, HCV genotype identification, liver function panel results, and detailed hepatologist assessments. This template organizes all required information into a clear, logical flow that reduces administrative burden while ensuring completeness.

Key features include:

• Structured sections for patient demographics and insurance details
• Comprehensive clinical history capture including previous treatment attempts
• Dedicated fields for HCV RNA viral load, genotype/subtype, and fibrosis staging
• Complete liver function test documentation (AST, ALT, bilirubin, albumin, platelets, INR)
• Hepatologist attestation and treatment plan justification
• Requested medication details with dosing and duration

How Paperform Enhances Your Prior Authorization Workflow

Paperform's conditional logic ensures only relevant questions appear based on patient history and treatment type. The form can be embedded directly into your EHR portal or sent as a secure link to referring providers.

Connect this form to Stepper (stepper.io) to automate your post-submission workflow—automatically route completed requests to billing staff, send confirmation emails to patients, update your practice management system, or create follow-up tasks for insurance verification. When approvals come through, use Papersign (papersign.com) to collect any required patient consent signatures electronically, keeping all documentation linked to the original authorization request.

With Paperform's GDPR and SOC 2 Type II compliance, your patient data remains secure throughout the authorization process. Replace outdated PDF forms and fax submissions with a modern, mobile-friendly solution that accelerates treatment access for your Hepatitis C patients.