HCV DAA Treatment Appeal Letters
The template letters below are offered to help with challenging health plan coverage denials of Direct- Acting Antivirals Agents. The letters may be downloaded and modified for submission to health insurers.
Acknowledgements: Thank you to Kris Kowdley, MD with Swedish Medical Center for contributing the draft template letters.
Denial Appeal - GT1 8-Week Sovaldi for INF Contraindicated Patient.docx
Denial Appeal - GT1 Harvoni Re-Treate Post Sofosbuvir and Ribavirin Relapse.docx
Denial Appeal - GT2 Re-Treat with Sovaldi and Riba Post INF-Riba Fail.docx
Denial Appeal - GT3 Naive 12 Wk Treatment With Daklinza-Sovaldi.docx
Denial Appeal - Generic GT3 Naive 12 wks F0-2 DacSof.docx
Denial Appeal - GT1 12-24-Week Harvoni and Riba for decompensated INF Contraindicated Patient.docx