Your Healthcare, Our Commitment: Understanding Prior Authorization at Clever Care

At Clever Care, we believe you deserve to know exactly how we’re working for you behind the scenes. When your doctor recommends a specific treatment or medication, sometimes we need to review it first through a process called “prior authorization.” Think of it as our way of making sure you’re getting the right care at the right time while keeping your costs manageable.

We know that waiting for approval can feel stressful when your health is on the line. That’s why we’re committed to making this process as smooth and transparent as possible. Below, you’ll find detailed information about how we’ve handled prior authorization requests from our Clever Care family over the past year.

What These Numbers Mean for You

Prior authorization is simply when we review a treatment or medication before you receive it to ensure it’s medically necessary and covered under your plan. We handle two types of requests:

• Standard requests: Regular reviews that typically take a few days
• Expedited requests: Urgent reviews when you need care quickly

The data below shows our commitment to saying “yes” to your healthcare needs whenever possible. You’ll see that we approve the vast majority of requests quickly, and when we can’t approve something initially, we provide a clear path for you and your doctor to appeal that decision.

We’re proud to share these numbers because they reflect our promise to you: we’re here to support your health journey, not create barriers to the care you need.