When to call for Pre-authorisation
Your treating facility, or you when necessary, need to obtain pre-authorisation for the following types of medical treatment.
This will ensure that we can assist you with your case, that you have access to quality care, and that your claims will be processed against the correct benefits:
- Hospitalisation (elective or planned and non-elective or emergency admissions)
- Cancer treatment (inpatient and outpatient)
- Renal (kidney) dialysis (inpatient and outpatient)
- Specialised radiology (inpatient and outpatient)
- Emergency evacuation (in-country and international)
- Chronic medicines
- An appliance or a prosthesis
- Organ transplants
- Ambulance services (air and road)
- Specialised dentistry
How to contact us for pre-authorisation
You or your healthcare provider can contact us by telephone or email, using the contact details below, at least 48 hours (2 business days) before any planned admission.
In the case of an emergency hospital admission, you should ask a friend or family member to contact us for pre-authorisation, within 48 working hours of the event, to ensure that your claims are paid. Or, if it is a weekend or public holiday, they should contact us on the next working day.
Information we need:
- Patient’s full name, policy number and date of birth
- Treating healthcare provider details: full name and practice number
- Hospital details: full name of hospital and practice number
- Reason for admission or emergency visit (medical and/or surgical condition)
- Date of admission and proposed date of the procedure
- Additional supporting documents where required
- When a procedure is done out of hospital, for example, MRI (out-patient radiology), you need to supply the healthcare provider’s name and practice number
We will give you feedback within 48 hours (2 business days)
We will send you an email within 48 hours (2 business days) to let you know the outcome of your request. You will receive a pre-authorisation number as part of the email when we approve a request.
Please update us regularly on your hospital stay
You and your healthcare provider need to update us regularly on the level of care that you need and the length of the hospital stay required. Payment will be made based on the pre-authorisation and available benefits.
Please see our contact details below.
We would like to process your claims as quickly as possible. Please help us by obtaining pre-authorisation for treatment listed above.
You or your healthcare provider should also update us regularly on the level of care and length of stay required for your treatment.
Payment will be made based on the pre-authorisation and available benefits.