The first form is an example of the form used to request reimbursement for the purchase of ure-Na . Most insurers call this form a medical expense claim form or medical expense reimbursement form.
The second form or the pre-determination form is an example of the form that is used to pre-authorize medical services or supplies. This form may also be named a Pre-Authorization or Prior Authorization for Medical Services form.
The number one issue we see when requesting coverage for ure-Na is when the insurance company is contacted, the customer service agent thinks that ure-Na is a prescription drug and they send the form for Rx Prior Authorization.
The forms needed are for medical benefit.
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