Trust & safety
Prescription NAD+ therapy through Vivo, explained
Published
People considering a prescription NAD+ product through a telehealth service usually ask process questions first: who decides, who fills the prescription, what happens next, and who pays. This guide answers them for Vivo specifically, in the same terms Vivo's Terms of Service and Privacy Policy use.
The short answer: a licensed provider decides, a licensed pharmacy dispenses, and you pay directly.
Six facts cover most of what people ask first.
- Who decides: an independent, licensed provider with Arora Health & Aesthetics, LLC, the affiliated medical group, reviews your intake and decides whether to prescribe. Vivo Health LLC does not prescribe or diagnose.
- Who dispenses: VialsRX, a licensed US 503A compounding pharmacy in Houston, TX. The dispensing pharmacy is identified on your prescription label.
- After intake: the provider issues a prescription, asks for more information, or declines. If a prescription is issued, the pharmacy compounds it and ships it to you.
- What the price covers: the price shown on a Vivo product page includes provider review, the compounded medication, and shipping. The exact amount and billing interval are shown at checkout before you are charged.
- FDA status: compounded medications are not FDA-approved drug products, and FDA does not verify their safety, effectiveness, or quality before they are marketed.
- Insurance: Vivo does not bill insurance, and all services are self-pay. Questions about your own coverage go to your insurer; questions about a Vivo charge go to care@vivoclinic.org.
A licensed provider with the affiliated medical group makes the prescribing decision.
Your intake is reviewed by an independent, licensed provider with Arora Health & Aesthetics, LLC. Providers are licensed in the states where they practice, and your prescribing provider is identified on your prescription.
Vivo Health LLC is the technology and administrative company that operates this site, the intake, billing, and support. It does not prescribe, diagnose, or practise medicine, and you do not enter a provider-patient relationship with it.
The review ends in one of three ways: a prescription, a request for more information, or a decline. A decline is a clinical outcome, not a service failure. If treatment is not approved, no prescription is issued and you are not charged for medication.
Review is usually asynchronous, but not always.
Care is typically asynchronous: you complete a written intake, and a licensed provider reviews it later. Depending on the telehealth regulations in your state, a live video or phone visit may be required before a provider can prescribe. A provider can also ask for one, or for lab results or more information, when it is clinically indicated.
Some state laws limit prescribing certain medications without an in-person examination, and a provider may decide that care through telehealth is not appropriate for you and refer you for in-person evaluation.
You must be 18 or older and physically located in a state where the medical group and the pharmacy are authorized to operate, both when you complete the intake and at each refill.
If a prescription is issued, VialsRX compounds it and ships it to you.
Vivo's NAD+ product is NAD+ Nasal Spray: a compounded nasal spray solution of nicotinamide adenine dinucleotide (NAD+), administered intranasally and available by prescription only.
A prescription is transmitted to VialsRX, a licensed US 503A compounding pharmacy, which compounds, dispenses, and ships it to the address you provide. A compounded medication is prepared for one individual prescription rather than manufactured in batches for retail sale.
Medication ships in temperature-regulated packaging. Follow the storage directions and the beyond-use date on the pharmacy label. A certificate of analysis is issued for each batch; to request the one covering your fill, ask your prescribing provider or contact the dispensing pharmacy.
Refills require an active prescription and continuing provider review.
Refills are not automatic indefinitely. Prescriptions expire, and continued refills require periodic reassessment on a schedule set by the licensed provider and applicable law. A refill may require an updated health assessment or provider review.
If a provider determines that continued therapy is no longer appropriate, or a required reassessment is not completed, the subscription is paused or ended, and you are not charged for a cycle that does not ship.
Any change to a prescription is the prescribing provider's decision. Each medication offered through Vivo has its own intake and requires its own prescription.
Subscriptions renew on the cycle you select until you cancel. The full renewal and cancellation terms are in Vivo's Refund Policy, and questions about an order go to care@vivoclinic.org.
Vivo does not bill insurance; every service is self-pay.
Vivo is not an insurer and does not bill insurance. Vivo and the medical group do not participate as providers in Medicare, Medicaid, or any other federal or state health care program, and no claim is submitted to one for anything provided through the service.
The service is not health insurance and does not replace it. Whether an expense could be reimbursed under your own plan is a question for your insurer or plan administrator. A question about a Vivo charge goes to care@vivoclinic.org.
The intake is where a licensed provider reviews your history and decides whether a prescription is appropriate.
Who holds your health information, and on what terms.
Arora Health & Aesthetics, LLC and VialsRX are HIPAA covered entities, and they hold the protected health information in your intake and prescription. Vivo Health LLC is not a HIPAA covered entity. It accesses that information only as a business associate of those two entities, under a written business associate agreement, to perform administrative services on their behalf.
The medical group's Notice of Privacy Practices describes your rights over that information, and requests for your medical record go to the medical group's privacy officer.
Account details you give Vivo directly — name, email, shipping address, phone number, and transaction information — are handled under Vivo's Privacy Policy. Vivo does not sell personal information.
Compounded medications are available by prescription only, after review by a licensed provider, and are not FDA-approved drug products. This article is general information about the process, not medical advice.
Sources
- Compounding and the FDA: Questions and Answers — U.S. Food and Drug Administration
- Compounding Laws and Policies — U.S. Food and Drug Administration
- Terms of Service — Vivo Health LLC
- Privacy Policy — Vivo Health LLC