1 reviews | Active since Jan 2018
Hospital Authorisation Process
My father saw the specialist today at 9h30. The specialist immediately requested that we get authorization for ICD 10 Code -I63.3 (STROKE) I called Topmed Pre-Authorizations and the agent asked me for symptoms of the patient and then insisted on the treatment plan. I am not the doctor but correct me if I am wrong, if the necessary test are not done, how can the doctor give a treatment plan without establishing the damage caused by the stroke and the way forward?
The specialist then wrote the motivation letter ( I received 12h20) stating that "a stroke is a serious condition" and I submitted that to them. Calling them to notify that I have send the email and was advised that they will communicate via email on the authorization. After 40 minutes I called back and asked for the authorization update, only to be informed that they receive a high volume of emails, and it will take 2 hours for the email to be processed.
According to GOOGLE:
A stroke is a serious life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. Strokes are a medical emergency and urgent treatment is essential. The sooner a person receives treatment for a stroke, the less damage is likely to happen.
But TOPMED needs the treatment plan before giving authorizaton!!!
You tell me if I am being unreasonable for trying to get my dad admitted ASAP and have NO appreciation for TOPMED's attitude towards this case?
The authorisation has been released as per the call with our Pre-authorisation department.
Kind Regards
Shaun Gaines
TopMed Medical Scheme
The authorisation has been released as per the call with our Pre-authorisation department.
Kind Regards
Shaun Gaines
TopMed Medical Scheme
