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24h Emergency: 084 124

Pre-authorisation

Before you are admitted to hospital for any procedure, you need to call or email us and get an authorisation number. This will ensure that you are covered for the procedure. Only services that are within the funding guidelines of the Scheme are covered.
Below is a checklist of all the information you need to have on hand in order to get your authorisation number.

Checklist

  • Membership number as printed on the membership card
  • Name and date of birth of the person needing authorisation
  • Date of admission
  • Date of operation (if applicable)
  • Name of the treating doctor and the practice number
  • Name of the hospital and the practice number
  • The reason for the admission to hospital (for example, tonsillectomy, chest pain or stroke)
  • The ICD–10 code/s – these are codes that specify the specific diagnosis and can be obtained from the treating doctor
  • If admitted for an operation, the procedure codes (tariff codes) the doctor intends using