PumpkinNow^TM Terms & Conditions

ABOUT PUMPKINNOW: PumpkinNow is an urgent pay service that expedites claims and estimates for critical and high-cost care of $1,000 or more, staffed by a dedicated team of claims managers, adjusters, and customer advocates. This priority, fast-track process helps pet owners and hospitals proceed with treatment in time-sensitive, high-stress scenarios without the added friction of complex claims processes, coverage uncertainty, or prolonged out-of-pocket periods for covered expenses for eligible claims.

I. GENERAL REQUIREMENTS: All PumpkinNow requests, including estimates and claims, must be:

• • Submitted by pet owners through their Member Center, or
  • Submitted by veterinary staff through their hospital’s Paw Portal
  • And made during the service hours: Mon–Fri: 8 AM – 7 PM EST, Sat: 9 AM – 4 PM EST

II. ESTIMATE PRE-APPROVALS: Estimates for future or scheduled treatment of any amount are eligible for expedited review with PumpkinNow. 

An estimate pre-approval is a statement known as a ‘Pre-Authorization Summary.’ It is not a guarantee of coverage or a bill. Authorized amounts are subject to change based on actual services rendered on the submitted claim form upon final review. A pre-authorization and estimate is void 30 days from the completion date or termination of the current policy period or the effective date of any midterm policy changes. Coverage is subject to your co-pay and any applicable deductible up to the limit of liability. Any summary is based on the information available at the time of the pre-authorization and is void if the diagnosis is found to be an ineligible condition or secondary to an ineligible condition.

III. CLAIMS APPROVALS:  Claims for covered veterinary services costing $1,000 or more are eligible for expedited review with PumpkinNow.

The expedited processing of claims requires all necessary information about the visit and the pet’s medical history to be available at the time of the review. These requirements include:

• • A completed estimate or claim form, including visit details in the description
  • All medical records were uploaded when the pet owner enrolled in Pumpkin, and/or
  • The pet’s complete medical history records were previously reviewed

IV. CLAIM PAYMENTS: If a PumpkinNow claim request is approved, the covered amount will be sent via direct deposit to the pet owner’s bank account. If their account is with an RTP-enabled financial institution, they will receive funds in as little as 15 minutes and may use them to help pay their veterinary bill. Otherwise, the deposit may take 1-3 days to appear in their account, and the pet owner may need to pay the full veterinary bill at the clinic or make other arrangements with the clinic staff.

If a pet owner did not add an account for direct deposit to their profile, a check for the reimbursed amount will be mailed to them via standard USPS.

V. INELIGIBLE CLAIMS: Not all claims submitted under the PumpkinNow service will be eligible for expedited review and/or payments. Reasons for this may include the dollar amount, claim complexity, incomplete medical records or history, and service hours.

IMPORTANT: PumpkinNow does not support direct payments to hospitals. Allowing a client to leave without paying a deposit or invoice is at the discretion of the hospital and pet owner.