Pre-authorisation for hospitalisation

If you require hospitalisation for procedures and treatment you need to obtain prior approval from your Healthcare Fund.

This can be conveniently performed via webchat (by clicking on the links in the table below) or WhatsApp channels. Alternatively, you may obtain pre-authorisation telephonically:

When contacting the Fund via any of the available channels for hospital pre-authorisation, you need to have the following information on hand:

1. Your membership number
2. The practice number of the referring doctor
3. The practice number of the doctor performing the procedure
4. The date of admission to hospital or clinic
5. The hospital or clinic practice number
6. The ICD-10/procedure code/s
7. The type of procedure/operation (where applicable)
8. The expected length of stay

Once the hospitalisation has been approved, you will receive an authorisation number that is valid for 30 days from the date of issue. You are required to provide the authorisation number to your treating healthcare provider and the relevant hospital or clinic.

The authorisation number confirms that benefits are available and guarantees your admission, provided that your contributions are paid up to date; however, it is not a guarantee of payment.