No pre-authorisation
The scheme says it did not authorise the service before it was rendered.
Words you might see
- “pre-authorisation was not obtained”
- “no authorisation”
- “authorisation was not granted”
Questions to ask
- What is the scheme’s rule on obtaining authorisation for this service, and where is it published?
- Does the scheme’s rule provide for authorisation after the fact in an emergency, and what does it require?
- Please provide the record of any authorisation request received for this service and the date it was received.
- What penalty was applied for the absence of authorisation, and how was it calculated?
Details to have ready
- Whether the admission or service was an emergency.
- Whether you or your provider contacted the scheme before or during the service.
Pryse is not a law firm and does not act for you. Nothing here is a determination of your rights or legal advice, and no registered scheme rule is quoted. The questions ask your scheme to provide its own.