This post is a follow up to my previous post where I describe my disgust at the difficulty I had in obtaining pre-authorisation for medical treatment covered under my health insurance policy from William Russell. In the two months since, I have learnt a lot about the pitfalls in obtaining private medical treatment, so I decided to write a post about the ins and outs of obtaining Pre-Authorisaton for medical treatment from William Russell. I spent one month exchanging emails with a member of William Russell’s staff trying to figure out why the process was so difficult and if there was any way the process could be made easier.
~ the questions on the pre-approval form are provably needlessly difficult to answer – all William Russell actually need is the names of hospitals, not doctors, dates etc.
~ pre-existing medical conditions are the problem – the two clear years clause – doesn’t just mean that you have had the policy for two years. Also, changing policy (e.g. silver to bronze) resets this period.
~ the amount of time it takes to obtain pre-approval can be prohibitive towards obtaining medical treatment AFTER obtaining pre-approval
~ need to prevent blaggers is understood – or is it – why would anyone seek treatment unless they needed it?
~ priorities should be: maintain profitability, provide services as promised, maximise profits. NOT, maximise profits, provide services when not able to get out of it
Update: I have received new information regarding someone else’s claim that was turned down even though they’d had two clear years free of symptoms etc. The detail seems to be in the moratorium option. Under investigation…
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