المملكة: Urgent – 500 riyals is the limit for prior approval for external treatment
Confirm Health Insurance Council The importance of adhering to prior approval procedures for treatment to ensure the speedy completion of applications and the continuity of Health services for beneficiaries, explaining the cases that require obtaining prior approval from the insurance company.
The Council explained that outpatient services require prior approval if the cost of treatment exceeds 500 riyals, while hospitalization cases and operations require obtaining prior approval in all non-emergency cases, including one-day operations.
Prior approval
The Council indicated that physical therapy services require prior approval after The first session is when you want to complete the treatment plan, in accordance with the procedures approved by Health insurance.
As for emergency cases, the Council stated that treatment begins immediately without waiting for approval, provided that the procedures for obtaining it are completed within 24 hours of the patient’s entry into the health facility.
Approval requirements
The Health Insurance Council stressed that knowing the requirements for prior approval contributes to accelerating procedures and avoiding any delay in obtaining health services covered by insurance coverage, ensuring a more efficient treatment experience for beneficiaries.
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