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Hospital Benefit Management

Hospital Benefit Management

POLMED’s Hospital Benefit Management Department assists members in obtaining authorisation before being admitted to hospital or undergoing any other examinations specified by the Scheme for pre-authorisation. Pre-authorisation of hospital admissions and out-of-hospital care is a key component in managing access to affordable, appropriate, safe and quality healthcare.

Helping you get the best care
Our team of doctors and registered nurses has been chosen to ensure maximum healthcare from available resources by assisting you in making informed decisions, offering useful advice, and liaising with you and your healthcare providers. By rendering this specialised service, we are able to ensure that you and/or any member of your family are admitted to the appropriate facility at the correct fee. If your stay in hospital exceeds the approved number of days, the hospital Case Manager will contact the Scheme regarding the proposed changes, including ward movements or extra theatre visits.

All admissions (hospital and day clinics) as well as Specialised radiology must be pre-authorised to avoid financial penalties. For further information, please refer to POLMED’s General Rules.

The pre-authorisation process is both quick and informative. For details on how to obtain the required pre-authorisation number, please view POLMED’s Hospital Pre-authorisation process.

Certain procedures will be funded from the hospital benefit if done in a doctor’s rooms and day clinics. View the list of procedures here. If these procedures are done in hospital, the member may be liable for a co-payment, except in the case of an emergency. If these procedures are done in a doctor’s rooms, there is no need for pre-authorisation.

Contact Details
POLMED Hospital Benefit Management Department
Tel: 0860 765 633 (members) or 0860 104 111 (providers)
Fax: 0860 104 114