The pre-authorisation process ensures that the treatment or procedure is both necessary and appropriate. Except in emergencies, pre-authorisation must be obtained 48 hours before any hospital admission.
Pre-authorisation is required for the following, among others:
- all admissions to hospital
- outpatient treatment in a hospital, i.e. when you do not stay overnight at the hospital
- admission to a day hospital
- MRI or CT scans or radio-isotope studies
- Access to patient care programmes
- emergency ambulance transportation
- specialised and surgical dentistry in hospital
- visits to a specialist if you are on the Custom and Essential options
- additional consultations on the Classic and Classic Network options once your savings are depleted
Ask your healthcare practitioner for a full description of:
- the reason for admission to hospital or for the scan
- the associated medical diagnosis
- the planned procedure
- all the tariff and ICD-10 codes that the doctor intends to use
- Additional information required
- Your membership number
- Name and date of birth of the patient
- Date of admission
- Name and practice number of the provider
- Name and practice number of the hospital
Remember: In case of an emergency you may obtain authorisation within 48 working hours. Any of your relatives/family/friends may phone to obtain a pre-authorisation number if it is not possible for you to phone.
You may request a quotation for planned procedures prior to the admission by sending the quotation to email@example.com.