· Patient’s name and surname
· Medical Aid name and membership number
· Patient’s Identity number
· Hospital name and practice number
· Doctor’s name and practice number
· Date of procedure
· ICD 10 codes for procedure
· Name of Procedure
· Procedure codes
· Please read and check that all the information on the doctor’s letter, requesting for
authorisation is correct.
I will share with you a recent happening where a Dad called me to say that his son needed a procedure on his left leg, in hospital. He would then call me back to authorise the event as soon as the doctor provided the letter. 2 Days later, I received the letter via email. The letter stated that the procedure was going to be done by Dr John at Hospital X, on his right leg.
From my discussion with the dad, 2 days before I remembered that he mentioned that the procedure was going to be on the Left leg. I called the Doctors room to verify the details on the leg, the receptionist who typed the letter could not confirm the information. I called the dad and he then confirmed that the procedure is on the Left leg and not on the Right leg.
The letter further only mentioned 1 hospital name on the Letterhead details, the dad assumed that the procedure was taking place at Hospital X.
We then received the letter of authorisation and approval from the Medical aid company.
The child had to be at the admitting hospital by 6am for his procedure. When he arrived at the Hospital X, he was told that on a Friday morning, Doctor John operates in Hospital Y and the child was not booked for theatre at hospital X.
The family then drove to hospital Y where the nursing staff was waiting for him.
Kindly please check and confirm that you have all the necessary information to obtain approval on a Pre-authorisation number for any in hospital admission.
Another great reason why you need someone on your team, trust PBA. Phone: 011 803 9686
Email: vivian@pbabrokers.co.za Fax: 086 552 3057 Have you considered life cover for your parents, parents in law or a special family member? Find out more by clicking on the link below.