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International Patient Centre

Medical aid and pre-authorisation

Cross-border treatment is usually subject to prior authorisation by the patient's medical aid or insurer. The practice prepares the clinical documentation that funders require.

Documentation provided by the practice

Clinical motivation letter

A letter describing the reason for referral and the proposed consultation or procedure, based on the information supplied by the referring doctor. It is updated after the in-person consultation if needed.

ICD-10 and procedure coding

Diagnosis codes (ICD-10) and procedure codes for the planned intervention, formatted to the funder's requirements.

Itemised quotation

Estimated surgeon, anaesthetist and hospital costs. Hospital costs are quoted separately by Netcare.

Proof of registration

The specialist's HPCSA registration and practice number, and provider registration with the relevant fund where applicable.

HPCSA MP 0000000 · Practice no. 0000000 · Recognised provider for Pula Medical Aid Fund (Pr No. 227978)

By country

Botswana

  • Pula Medical Aid Fund

    Recognised provider for Pula Medical Aid Fund (Pr No. 227978). Patients remain solely responsible for obtaining pre-authorisation and confirming benefit limits directly with their scheme or insurer before consultation or travel.

  • Botswana Medical Aid Society (Bomaid)

    Some benefit options may include cover for referral to South African private hospitals, subject to the scheme's pre-authorisation rules. Confirm your option's cover with Bomaid directly.

Zimbabwe

  • Cimas Health Group

    Cimas may consider referral to Johannesburg, subject to its own pre-authorisation process and your benefit option. Confirm cover with Cimas directly.

  • Other Zimbabwean medical aid societies

    Confirm cross-border cover and required documentation with your fund before travel.

Zambia

  • Zambian medical schemes and corporate health plans

    Some schemes and employer plans cover treatment in South Africa with prior authorisation. Confirm your benefit option and required documents before travel.

  • International health insurers

    Guarantee-of-payment letters are generally required before elective admission.

Mozambique

  • International health insurers

    Some expatriate and corporate policies cover specialist treatment in South Africa, subject to pre-authorisation. Confirm your policy's cover directly with your insurer.

  • Mozambican private medical plans

    Confirm cross-border cover and required documentation with your plan before travel.

Patients remain solely responsible for obtaining pre-authorisation and confirming benefit limits directly with their scheme or insurer before consultation or travel.

Benefit rules differ between funds and options and change from year to year. Authorisation is at the discretion of the funder. Funder names are listed for information only and do not imply endorsement of the practice by any funder.