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Insurance Pre-authorization FAQs

Learn more about insurance pre-authorizations

Yohann Allen avatar
Written by Yohann Allen
Updated over 4 years ago

1. Can you confirm if my treatment is covered by my insurance policy?

To confirm if a treatment is covered under your policy, check your policy benefits on the Bayzat app under Health Insurance.

Watch this video to learn how.

Alternatively, you can also request the table of benefits from your HR team for services that are covered under your insurance.

2. Where can I go for my treatment (any type of treatment) and is it within my network? 

You can find out facilities in your network for a specific treatment by searching for your treatment type on the Bayzat app under Health Insurance.

Watch this video to learn how.
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Alternatively, you can request a copy of the network list from your HR team and treatments within your network.

3. Why is my pre-authorization request delayed?

Delays can be due to 2 reasons:

  • The insurance desk at the medical facility you visited has not sent the necessary documents to the insurer on time (due to backlog of requests or admin error).

  • The insurer is requesting additional documents or clarification from the hospital/facility where you are getting treated. Any delay in sending this information to the insurer will in turn delay your request.

You can refer to Bayzat’s pre-authorization guide here. Alternatively you can reach out to us directly on our chat box, providing your contact details and insurance card number.

4. My physiotherapy session was rejected by the insurer, why?

Physiotherapy sessions are usually rejected due to the treating doctor not providing a progress report to the insurer. This report is required by your insurance provider after 5 sessions to understand if additional sessions are required.

You will either receive an SMS from your insurer or call mentioning that your treatment has been rejected with additional details.

5. Do I need a pre-approval before I carry out my treatment? 

You will require pre-approval from your insurer for the following treatments:

  • A specific or high value treatment at a network medical facility such as surgery, MRI, lab tests, physiotherapy or inpatient treatment (non emergency)

  • Treatments requested in a medical facility outside of your direct billing network

  • Treatments requested in a medical facility outside of UAE 

6. Why is my pre-authorization request rejected?

You will either receive an SMS from your insurer mentioning that your treatment has been rejected or while you are at the medical facility availing treatment, the insurance desk will inform you about your treatment being rejected. 

Rejections can be due to any of the following reasons:

  • The treatment is not covered by your insurance policy terms and conditions

  • The medical justification required by your doctor to avail the treatment has not been provided or is not sufficiently detailed 

  • The policy limit for the requested treatment has already been fully utilized

  • The treatment is related to a pre-existing condition that has not been declared at the inception of the policy, and medical history was required to be declared on your policy.

You can refer to Bayzat’s pre-authorization guide here. Alternatively you can reach out to us directly on our chat box, providing your contact details and insurance card number. 

7. How do I get a pre-approval for my treatment (within and outside the UAE)?

If you have been advised by your doctor to get a treatment that requires a pre-authorization from your insurer, you will need to inform the insurance desk at the medical facility to send a pre-authorization request to the insurer along with all your medical reports to initiate the process.

Before availing treatment at a facility outside the UAE, please make sure you inform the insurer in advance. To initiate a pre-authorization outside the UAE, you can reach out to us on claims@bayzat.com regarding all your treatment details and we will liaise with the insurer to process your pre-authorization.

You can refer to Bayzat’s pre-authorization guide here. Alternatively you can reach out to us directly on our chat box, providing your contact details and insurance card number. 

8. What tests are covered for my wellness check/routine check up? 

Before starting your routine wellness check up, please view your policy benefits on the Bayzat app under Health Insurance to understand what benefits and care is covered.  

Watch this video to learn how.

If you need a more detailed list, please request your policy Table of Benefits from your HR team. Tests that are not mentioned on your policy table of benefits will not be covered by the insurer.

9. Am I covered for emergency cases outside the UAE?

To confirm if emergency coverage is included in your policy, please check your policy benefits on the Bayzat app under Health Insurance.

Watch this video to learn how.

Alternatively, you can also request the table of benefits from your HR team for services that are covered under your insurance.

10. My medical card was rejected at the medical facility, why?

If your medical card is rejected at the medical facility, call the 24/7 toll free number on the back of your medical card. A customer service representative will be able to guide you on the reason for rejection. 

You can reach out to us directly on our chat box, providing your contact details and insurance card number.

11. Can I get a Guarantee of Payment (GOP) from my insurer if my policy is not active or under renewal?

Yes, a GOP can be provided by the insurer provided that the medical facility is within your network and you are covered for the treatment based on your policy table of benefits. To initiate a GOP request, you can reach out to us on claims@bayzat.com with your treatment details.

12. My insurer has rejected my request with reason "not medically indicated", how can I get it approved?

Not medically indicated means that the insurer requires additional test results, lab or medical reports to evaluate the case further before granting approval. This is usually requested for treatments that are of a higher value so that the case can be assessed accurately by the insurer.  

Please note that additional information can ONLY be sent by the hospital/clinic to the insurer directly.

13. Who can I contact to follow up on my pre-authorization request status during the weekend? 

You can follow up on your pre-authorization request by calling the 24/7 toll free number at the back of your insurance card. A customer service representative will be able to guide you on the status of your request.

14. Can you recommend a specialist or medical provider for my treatment?

Neither Bayzat or the insurer are allowed to recommend specialists or medical providers for your treatment. This choice is left to the member's discretion.  

15. How do I know what services are covered under my maternity benefit?

You can check your maternity coverage on the Bayzat app under Health Insurance by searching for maternity to view all the benefits and care covered by your policy.

Watch this video to learn how.

Here is some additional information regarding maternity that may help you out. 

Alternatively, you can request your policy table of benefits from your HR team. Services that are not mentioned on your policy table of benefits will not be covered by the insurer.

16. I do not have my medical insurance card, can I get treatment? 

If the treatment is within your network and If your policy is active, the insurance desk at the medical facility can confirm your eligibility by calling or emailing your insurer directly. If the treatment is outside your network and your policy is active, you will be covered as per your table of benefits and will have to pay and claim a reimbursement for your payment.

17. What vaccinations are covered as per DHA?

Please refer to the updated list of vaccinations and immunization guidelines on the DHA website.

18. How do I know which hospitals are covered within my network?

You can find a list and map view of all the hospitals and clinics within your network on the Bayzat app under Health Insurance. 

Watch this video to learn how.

Alternatively, you can either call the 24/7 toll free number at the back of your insurance card and ask the customer service representative if a specific provider is within your network. Also, a full network list specific to your policy can be provided by your HR team. 

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