Overview
Dis-Chem Health is a trusted name in healthcare, renowned for its commitment to providing comprehensive medical coverage and exceptional service to its members across South Africa.
As a leading medical insurance provider, Dis-Chem Health offers a wide range of benefits, including hospital cover, chronic medication benefits, and day-to-day medical expenses, tailored to meet the diverse needs of individuals, families, and businesses.
In this guide, we’ll walk you through the simple process of obtaining pre-authorization from Dis-Chem Health, ensuring that you have access to the necessary healthcare services and treatments when you need them most.
When is Pre-Authorisation Required by Dis-Chem Health?
Pre-authorisation is required by Dis-Chem Health for the following:
✅ GP Visits: Dis-Chem Health covers four GP visits. Pre-authorisation from Ask A Doctor is needed from the 3rd GP visit
✅Acute medication: Pre-authorisation must be obtained for the prescribing Doctor visit for acute medication
✅ Dental:
- For dental cover, pre-authorisation is needed for four or more repairs to teeth, or five or more composite fillings per Family Per Annum
- Cover for emergency root canal during Office Hours for pain and sepsis only.
- Pre-authorisation is needed for five or more dental extractions
✅ Pre-Authorisation is needed from the third oral radiography X-ray.
✅ Glasses: Pre-authorisation is needed for the glasses benefit
✅ X-rays and scans: Pre-authorisation with Ask A Doctor is needed from the third Doctor visit for tests on X-rays and scans
✅ Blood tests: Pre-authorisation with Ask A Doctor is needed from the 3rd
Pre-authorization with Dis-Chem Health is typically required for certain medical services or treatments that are considered non-routine, elective, or costly.
Pre-authorization ensures that the healthcare services or treatments you plan to receive are covered by your medical scheme. Without pre-authorization, you risk facing unexpected out-of-pocket expenses for services that may not be covered.
Pre-authorization often involves a review of your medical condition and proposed treatment plan by healthcare professionals. This process helps ensure that you receive the most appropriate and effective care for your health needs, promoting better treatment outcomes.
Failure to obtain authorization from Dis-Chem Health when required can have several consequences:
- ✅ Out-of-Pocket Expenses
- ✅ Reduced Coverage
- ✅ Disputes and Appeals
What information to provide when requesting authorisation
The information which you are required to provide will be relayed to you when applying for your pre-authorisation number, either through the Dis-Chem Health app or via a service consultant
How to Get Dis-Chem Health Authorisation
- You will need a pre-authorisation number.
- You can obtain this pre-authorisation number by logging a query through the Dis-Chem Health App to request for authorisation.
- Alternatively, you can contact Dis-Chem on 0861 029 892 to speak to a service consultant and obtain your pre-authorisation number.
Conclusion
This step-by-step guide provides a comprehensive overview of how to obtain pre-authorization from Dis-Chem Health, ensuring that you can navigate the process with ease and confidence. By following the outlined steps and providing the necessary information, you can streamline the pre-authorization process and receive timely approval for the healthcare services you need.
Remember, applying for pre-authorization from Dis-Chem Health is a simple and straightforward process designed to ensure that you receive the appropriate care and coverage for your medical needs. Take advantage of this guide to make the pre-authorization process as smooth as possible, allowing you to focus on your health and well-being.
