Why a pre-authorisation is refused
- Waiting period on the policy not elapsed — you control checking it, not the outcome.
- Condition excluded under the policy — outside your control, but knowable at admission.
- Procedure could have been done as day care — documentation controls this.
- Insufficient clinical justification — entirely within your control.
- Policy limits already exhausted — knowable before admission.
- Notification outside the window — within your control.