If you require hospitalisation for procedures and treatment, you need to obtain pre-authorisation.
The pre-authorisation process checks benefits availability and determines if a medical procedure is clinically required. The granting of pre-authorisation does not guarantee full payment of your claims.
Failure to obtain hospital pre-authorisation will result in you being liable for the full cost of hospitalisation and any related expenses.
In the event of emergency hospitalisation, where you are unable to obtain pre-authorisation, your spouse or a family member must inform the Fund within 48 hours (two days) of admission. This will enable the Fund to ensure you receive quality care and the account is processed correctly.
You must complete the Hospital Pre-authorisation Form to ensure that when you call for your hospital authorisation number, it will be a quick and easy process. Please note that there will be instances where a quote or motivation may be required. You will be issued with a hospital authorisation number once you have applied.