Hospital Autherization

Hospitalization authorization can be long and frustrating and a really difficult time for medical practitioners and their staff members. Here at HealthIT we have made the process easier for you. We take on the mundane process of calling the medical aid schemes and confirming authorizations. For planned admissions a minimum of 24hours is required to get the necessarily authorization. In the event of an emergency admission authorization is obtained within the first working day of the emergency. Due to our working relationship with most medical aids we make sure that claims are not rejected and that authorization is done on time and speedily For longer hospital stay extra procedures and services we assist with motivation and further authorization. Leaving you to take optimal care of your patients Once authorization is done and depending on the medical scheme , the following information will be sent to you:

•The unique authorization number
•The approved dependent
•The approved supplier
•The initial length of stay
‘ The code status according to scheme regulations

Members have to obtain authorization from Case Management for any planned hospital admission or procedure in a hospital, at least two (2) days prior to being admitted to hospital. In case of emergency admissions, authorization has to be obtained within 24-hours or on the first working day after the emergency. In the event of emergency treatment or admission to hospital over a weekend, public holiday or outside normal working hours, members must contact the Scheme for authorization on the first working day after the incident. If they do not obtain authorization for a planned event, or fail to authorize hospital treatment on the first working day after an emergency event, claims may be rejected for payment. Any admission or outpatient visit to a hospital must be authorized.

If a hospital stay is longer than expected Any additional days in hospital, multiple procedures or additional services require further authorization or motivation. It is crucial that members arrange with their doctor, the hospital case manager or a family member, inform the Scheme of the extended length of stay. If there is a clinical reason for the extended stay, the Scheme will approve the extra days. If not, the member will be responsible for the cost for the non-approved days and treatment.
Once the authorization request has been approved, a member will receive the following information:

‘ The unique authorization number
•The approved dependent
•The approved supplier
•The initial length of stay
•The status of all the codes (whether approved or rejected in accordance with the
Scheme Rules).

HealthIT endeavors to take you and your patients through these processes freeing you the medical practitioner to focus on more important matters of running your practice.