We provide pre-authorisation once benefits have been verified and Scheme Rules have been applied. If the hospital, doctor or any other third party obtains the authorisation on your behalf, it is important for you to check if you will need to pay any co-payments or shortfalls as a result of not using a Designated Service Provider, or due to benefit limits.
Follow these steps to get pre-authorisation:
Step 1 Phone our member call centre on 0860 117 859
Step 2 Make a note of the authorisation number
Step 3 Give the authorisation number to your service provider
When you phone the call centre, make sure you have the following information available:
- Membership number.
- The name and details of the patient.
- The reason for hospital admission, procedure or specialised scan.
- The procedure code (CPT), diagnosis code (ICD-10) and tariff code (these details are available from your treating doctor).
- The date of admission.
- The contact details and practice number of the referring GP.
- The contact details and practice number of the specialist.
- The name and practice number of the hospital, day clinic or radiologist.