It is always a good idea to do pre-certification with any sort of medical expense, just to be on the safe side. Although not always required, pre-certification (otherwise known as pre-notification) is definitely worth your time and effort.
What is Pre-Certification ? It is the process of simply letting your international health insurance company know about any upcoming medical services like planned surgery, hospitalization, or even diagnostic exams. It is not always necessary to get pre-certified for less complicated issues like doctor visits but it does not hurt to do so.
Please note that pre-certification is always required for any major medical service and failure to do it in advance of medical treatment will result in a financial penalty (a 50% reduction in benefits is typical among the international health insurance plans). However, it is not required for emergency hospitalization. If one has an emergency you can just let the insurance company know within a reasonable time frame, usually 72 hours is fine.
Pre-certification is very important for the international health insurance companies for many reasons. It allows the insurance company to:
1. Confirm whether the required medical care or diagnostic exam is covered by your policy or not.
2. Determine whether or not the medical care or diagnostic exam in question is appropriate for the patient (as a way to control health care costs and cut down on unnecessary medical procedures and exams).
3. Help the patient find the best hospitals and doctors to perform the procedure or exam in question.
4. Lastly, when notified in advance the insurance company can negotiate rates and help to cut down on erroneous billing and over-charges.
You should definitely contact your international health insurance company in order to pre-certify with plenty of time. Please contact us for details on how to do this or we can take care of it for you if you prefer.