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