Clinicals and Prior Authorization
What are clinicals?
Clinicals are medical records that show the care you’ve received. They can include recent appointment notes, test results, or treatment records. If your insurance requires clinicals, we’ll work with your doctor’s office to get the paperwork we need.
Why do I need clinicals?
Sometimes, insurance requires clinical documents to prove that motherhood items are medically necessary. We will work directly with your doctor’s office to get these documents (just like with your prescription!)
Why were my clinicals not accepted?
The most common reason clinicals are rejected is that they do not support the diagnosis code on the prescription. The prescription and clinicals need to work together. For example: if we receive a prescription with a diagnosis for back pain, the clin
What do I need to do if my insurance requires Prior Authorization?
Different insurances have different requirements for Prior authorization. While some may only require a prescription to start the prior authorization process, others may require additional documents, such as doctor's notes on the pregnancy, labor and
What happens if Prior Authorization is denied?
There can be a few reasons that your insurance denied prior authorization like, having received the maximum amount allowed for an item, duplicate requests, not enough documentation, or your insurance decided the item is not needed. If you have receiv