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Help · Pre-authorisation

Enhancements

An enhancement is a request to increase an approved amount because the case changed — a longer stay, an unplanned procedure, an implant.

  • Raised against the original authorisation, not as a new one.
  • Needs the clinical reason, not just the number.
  • The clock on an enhancement is usually shorter than the original.
  • An enhancement filed after discharge is the weakest position to be in.

More in Pre-authorisation

The pre-authorisation clockWhen it starts, what it is measured against, and what happens when it runs out.Why a pre-authorisation is refusedThe common grounds, and which of them you control.