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IN-HOSPITAL PRE-AUTHORISATION PROCESS - …
MANAGED CAREMANAGED CAREPOLMED 2017 Guide to your HealthPOLMED 2017 Guide to your Health! IN-HOSPITAL PRE-AUTHORISATION PROCESS IF PRE-AUTHORISATION IS GRANTEDAn authorisation number is given to the caller and immediately faxed/emailed to the hospital and your treating provider. You are notified of the decision and are required to liaise with your doctor if you are uncertain about anything. A penalty of R5 000 may be imposed if no PRE-AUTHORISATION is OPERATOR WILL ASK FOR THE FOLLOWING DETAILS: ID number Membership number Name of patient Date of birth Name of hospital /practice number Name of service provider ( doctor, specialist, etc.) andhis/her practice number The diagnosis (ICD-10) code The procedure to be performed (CPT4 or tariff code) The date of admission The name and telephone number of the caller Whether or not the treating doctor charges medical scheme ratesiIF FURTHER INFORMATION IS REQUIRED The admission request/procedure is queried with the hospital .
MANAGED CARE MANAGED CARE POLMED 2017 Guide to your Health POLMED 2017 Guide to your Health! IN-HOSPITAL PRE-AUTHORISATION PROCESS IF PRE-AUTHORISATION IS GRANTED
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