4. Pre Authorisation (PAR)

1. What is pre-authorisation (PAR)?

It is the prior approval of any planned admission to a hospital, including an associated treatment or procedure performed by a medical practitioner during hospitalisation.

MRI/CT-scans and radio-isotope studies, whether part of hospitalisation or not, require separate pre-authorisation, except for the following for which benefits are paid as for normal radiology:

• Dexa scans
  
• CT bone mineral density studies
  
• Certain clinical procedures, e.g. laser tonsillectomy, gastroscopy and colonscopy, are also subject to pre-authorisation when performed both in and out of hospital.

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2. When must I apply for a PAR?

Application should be made in advance, preferably as soon as admission is confirmed by your doctor. If you are unsure whether a specific procedure requires a PAR, please phone the Pre-Authorisation Centre for advice. Please ensure that you obtain a PAR at least two days prior to a planned procedure or treatment. In the case of an emergency, a PAR must be obtained within two business days following the incident.

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3. What happens if I do not obtain a PAR?

No benefits will be payable in respect of the hospital and related service providers' accounts.

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4. What are the PAR-Centres' contact numbers?

Admissions: 0860 104 974

Fax: 0860 467 727

E-mail: authorisations@selfmed.co.za

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5. Will associated costs be paid when a PAR was denied?

No, nothing will be paid in respect of such associated clinical procedure or treatment, including the specialist and anaesthetist`s accounts.