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Benefits Verification, Prior Authorization, and Appeals Workflow for Long-Acting ART and PrEP

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This downloadable resource provides a practical workflow for implementing long-acting ART and PrEP, including how to determine acquisition pathways, verify coverage, prepare prior authorization requests, and troubleshoot denials or access barriers before administration.

Released: June 02, 2026

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Provided by Clinical Care Options, LLC dba Decera Clinical Education

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Supporters

Supported by an educational grant from ViiV Healthcare.

ViiV Healthcare

Target Audience

This activity is intended for United States physicians, pharmacists, nurses, advanced practice providers, and other healthcare professionals who provide antiretroviral therapy for people living with HIV and/or PrEP for people who may benefit from it.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Apply practical strategies to complete benefits verification, identify payer requirements, and secure timely prior authorization for LA ART and LA PrEP for eligible individuals 

Disclosure

Primary Author

Rajanea Jackson, CPhT, has no relevant financial relationships to disclose.

Leslie Jones, LBSW, has no relevant financial relationships to disclose.

Larisa V. Niles-Carnes, MPH, has no relevant financial relationships to disclose.