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Use new eForms for Synagis, Hepatitis C medication authorizations
February 8, 2018

When requesting prior authorization for Synagis®′ and Hepatitis C medications, you can now submit your requests electronically with new eForms:

  • Massachusetts Standard Form for Hepatitis C Medication Prior Authorization Requests
  • Massachusetts Standard Form for Synagis® Prior Authorization Requests

Enter information about your request directly into the form, hit the “submit” button, and your request is sent right to us. The eForm replaces the PDF version of the form.

The form is now standard for Massachusetts health insurers to meet the requirements of Chapter 224. It was developed with The Mass Collaborative, a partnership of payers, providers, and trade associations.

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