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Pre-Approval required for OP equal to or exceeding AED 1,000 / QAR 1,000 / BD 100 / OMR 100 [excluding consultation]; AND for the services detailed. For Further Details Please Click here
Member Details
Member Name : MATHEW ANTHONY
Sponsor Name :
Policy No : 13/XI/72410/0
Membership No : 1/P/0
DHA ID : I010-000-120688531-01
Emirates Id : 784-1988-2174555-5 Date Of Birth : 26/03/1988
Area Of Cover : Local Uae Plus Elected Is VIP Member : No
PER SERVICE : Copay applicable per service type (Eg : Laboratory, Consultation , Radiology,etc.) CLINIC : Clinics/ Medical center INCL : Including OPT : Optical COINS/CO-INS : Co-insurance IP : In Patient OTH : Other CONS/CONSULT : Consultation LAB : Laboratory PH : Pharmacy Abbreviations : DENT : Dental MAT : Maternity PHYSIO : Physiotherapy
DIAG : Diagnostic MAX : Maximum R&B : Room and Board
EXCL/EX : Excluding OP : Out Patient RAD/RADIO : Radiology HOSP/HOSPIT : Hospital
**** SIGNATURE PRE-APPROVAL GUIDELINES ****
In-patient Pre-approval: Within 4 hours of receiving all required documentation
All in-patient, day care and invasive procedures require pre-approval; also including but not limited to: medical admissions, surgeries, chemotherapy and radiotherapy, dialysis, etc Out-patient Pre-approval: Within 1 hour of receiving all required documentation All out-patient consultations and investigations do not require approval EXCEPT in the following situations:
The net discounted amount including any investigation changes; and after removing co-pay and consultation is equal or exceeds AED 1,000 / QAR 1,000 / BD 100 / OMR 100
https://partners.gig-gulf.com/EligibilityCheck/CardVerification/MemberDetails.aspx?hasheddtlsdat=05872dd90a20d4660cc49ec9834c450a 1/2 4/24/24, 12:39 PM Member Card Details Magnetic Resonance Imaging (MRI) Computed Tomography (CT) & PET Scans Day care procedures; including but not limited to Endoscopies Speech therapy/Occupational therapy Vitamin D test Mammograms Intraarticular injections EEG/EMG/NCS Echocardiogram/TMT/Holter Monitoring Influenza A & B Physiotherapy Chiropractic treamtent Psychiatric treatment (including consultation and pharmacy) Maternity consultation: only the initial consultation will need pre-approval, succeeding consultations do not need pre-approval Maternity Investigations and related treatment. Inside Abu Dhabi: Maternity OP ( including consultation) do not require approval Alternative Therapy not limited to Osteopath, Homeopath, Acupuncture, Ayurveda, Chinese Traditional Medicine (including consultation and pharmacy) Services related to health screening Services for injuries or illness related to work, road traffic accident (RTA), or professional/dangerous sports Pharmacy: Providers with e-Rx/PBM should use PBM for all transactions Vaccination: Providers with e-Rx/PBM should use PBM Dental services (including consultation and pharmacy) Optical services Any treatment/procedure/investigations/ medications of chronic conditions for XP / XI policies (initial doctor consultation doesn’t require approval).
For non-Dubai based providers, please send all pre-approval requests to [email protected]
Benefit Name Coverage Benefit Name Coverage Benefit Name Coverage
Physiotherapy Work Related Injuries Pregnancy and Childbirth Alternative External prosthesis or appliances Psychiatric Dental Benefit Health Screen Benefit Vaccination Optical Benefit
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