DENTAL PRE-AUTHORISATION
Certain dental procedures that are performed in-hospital and out-of-hospital require pre-authorisation. The Polmed payment rules, clinical protocols and guidelines will also apply. After assessing the suitability of the procedure, Polmed will communicate the outcome of the pre-authorisation request to the member and treating provider.
Please refer to the current Polmed Guide to Your Health booklet for more information about dental benefits and pre-authorisation requirements.
What information does Polmed need to provide pre-authorisation for a dental procedure?
- A full diagnosis of the condition
- Treatment plan (tariff codes & ICD-10 codes)
- Clinical motivation
- Teeth numbers
- Laboratory codes (where applicable)
- Clear X-rays
If the above information is not provided, Polmed may not be able to authorise the procedure.
CONTACT DETAILS
In-hospital dental procedures pre-authorisation:
Tel: 0860 765 633 | |
0860 104 114 | |
polmedauths@medscheme.co.za | |
Download the free Polmed Chat app on your mobile device. | |
Login to the Member Zone and click on the Polmed Chat widget/icon. |
Out-of-hospital specialised dentistry in doctors’ rooms:
Contact Polmed to confirm available benefits and, if required, complete pre-authorisation:
0860 765 633 | |
dental.polmeddental@medscheme.co.za | |
Download the free Polmed Chat app on your mobile device. | |
Login to the Member Zone and click on the Polmed Chat widget/icon. |
