When a provider should call for pre-authorisation

The provider needs to obtain pre-authorisation for the following types of medical treatment. This is to ensure that all claims are 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
  • Antenatal and deliveries
  • Any surgery (Minor/Intermediate/Major) involving the use of anaesthesia

When a member should call for pre-authorisation

  • When accessing care outside the network (for a covered service)
  • When travelling out of the country of coverage (to confirm if the plan is covered outside the country in case of a refund)
  • Annual medical check-up

How to contact us for pre-authorisation

The health care provider can contact us by telephone or email, using the contact details below, 48 hours before any planned admission or at the point of service.

In an emergency, please call us within 24 hours after admission to authorise the treatment.

The member should also contact us by telephone or email, using the contact details below, 72 hours before any planned admission or procedure.

In an emergency, please call us within 24-48 hours after admission or after the treatment.

Information we need

  • Patient’s full name, and policy number
  • Treating healthcare provider details: full name and practice number
  • Reason for admission or emergency visit, that is, diagnosis (medical and/or surgical condition)
  • Date of admission and the proposed date of the procedure
  • Additional supporting documents where required

Feedback

We will give you a pre-authorisation immediately when you call and response to emails is usually before the close of business for that day or within 48 hours 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.

How to submit a claim

For more information on how to submit your claims, please click here.

24-hour Pre-authorisation
Contact Centre

Telephone
+234 708 068 7600
+234 1 448 2015

Email
casemanagement@totalhealthtrust.com

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.