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What is pre-authorisation?
This is the process whereby you notify the scheme that you are about to be hospitalized or that
you want to access benefits for which pre-authorisation is required. Services and treatments
that require a pre-authorization are indicated on the benefit options. The scheme will confirm
which benefits, and amount of benefit that is available.
For what do I need pre-authorisation?
- Any hospital admission (including Psychiatric hospitalization)
- Procedures in doctors rooms
- Rehabilitation
- Maternity Benefits
- MRI/CT Scans and radio isotape studies, interventional radiology and specialized radiology
- Access to Chronic and HIV/AIDS Medicine Benefit
- Dental surgery and specialized dentistry
- Refractive Surgery
- Basic dentistry in hospital for children under the age of seven
- Services and treatment as indicated on each benefit option
- Procedures in doctors rooms
- Rehabilitation
- Maternity Benefits
- MRI/CT Scans and radio isotape studies, interventional radiology and specialized radiology
- Access to Chronic and HIV/AIDS Medicine Benefit
- Dental surgery and specialized dentistry
- Refractive Surgery
- Basic dentistry in hospital for children under the age of seven
- Services and treatment as indicated on each benefit option
How is pre-authorisation obtained?
Pre-authorisation is obtained by contacting the scheme on 3624700 or sending an email to
botsogo pre-authorisation@metropolitan.co.bw Please have your membership number at
hand.
Your service provider may also request pre-authorisation on your behalf
The service provider needs to provide the diagnosis, the intended treatment and estimated cost
in writing as verbal pre-authorisation will not be permitted. This is subject to assessment.
A pre-authorisation number will be issued for the specific event as listed above or indicated in
the benefit structure upon approval.
Failure to acquire pre-authorisation
If a member needs emergency treatment outside of working hours or on the weekend then pre-
authorisation can be requested on the next working day.
Claims submitted without pre-authorisation will be rejected whether the claim is payable to the
member or service provided.
Emergency Situations
What constitutes an emergency?
The onset of a sudden health condition at the time that is unexpected and requires immediate medical or surgical treatment and would result in serious impairment to bodily functions or serious dysfunctions of a bodily organ or part, or would place the person’s life in serious jeopardy and even result in death.
Procedure to be followed
Call the Emergency Service Providers directly or Botsogo Health Plan on +267 73014111 for
immediate paramedic assistance. Depending on the situation, proceed to your nearest
emergency medical facility/hospital
What is pre-authorisation?
This is the process whereby you notify the scheme that you are about to be hospitalized or that
you want to access benefits for which pre-authorisation is required. Services and treatments
that require a pre-authorization are indicated on the benefit options. The scheme will confirm
which benefits, and amount of benefit that is available.
For what do I need pre-authorisation?
- Any hospital admission (including Psychiatric hospitalization)
- Procedures in doctors rooms
- Rehabilitation
- Maternity Benefits
- MRI/CT Scans and radio isotape studies, interventional radiology and specialized radiology
- Access to Chronic and HIV/AIDS Medicine Benefit
- Dental surgery and specialized dentistry
- Refractive Surgery
- Basic dentistry in hospital for children under the age of seven
- Services and treatment as indicated on each benefit option
- Procedures in doctors rooms
- Rehabilitation
- Maternity Benefits
- MRI/CT Scans and radio isotape studies, interventional radiology and specialized radiology
- Access to Chronic and HIV/AIDS Medicine Benefit
- Dental surgery and specialized dentistry
- Refractive Surgery
- Basic dentistry in hospital for children under the age of seven
- Services and treatment as indicated on each benefit option
How is pre-authorisation obtained?
Pre-authorisation is obtained by contacting the scheme on 3624700 or sending an email to
pre-authorisation@metropolitan.co.bw Please have your membership number at
hand.
Your service provider may also request pre-authorisation on your behalf
The service provider needs to provide the diagnosis, the intended treatment and estimated cost
in writing as verbal pre-authorisation will not be permitted. This is subject to assessment.
A pre-authorisation number will be issued for the specific event as listed above or indicated in
the benefit structure upon approval.
Failure to acquire pre-authorisation
If a member needs emergency treatment outside of working hours or on the weekend then pre-
authorisation can be requested on the next working day.
Claims submitted without pre-authorisation will be rejected whether the claim is payable to the
member or service provided.
Emergency Situations
What constitutes an emergency?
The onset of a sudden health condition at the time that is unexpected and requires immediate medical or surgical treatment and would result in serious impairment to bodily functions or serious dysfunctions of a bodily organ or part, or would place the person’s life in serious jeopardy and even result in death.
Procedure to be followed
Call the Emergency Service Providers directly or Botsogo Health Plan on +267 73014111 for
immediate paramedic assistance. Depending on the situation, proceed to your nearest
emergency medical facility/hospital
What is pre-authorisation?
This is the process whereby you notify the scheme that you are about to be hospitalized or that
you want to access benefits for which pre-authorisation is required. Services and treatments
that require a pre-authorization are indicated on the benefit options. The scheme will confirm
which benefits, and amount of benefit that is available.
For what do I need pre-authorisation?
- Any hospital admission (including Psychiatric hospitalization)
- Procedures in doctors rooms
- Rehabilitation
- Maternity Benefits
- MRI/CT Scans and radio isotape studies, interventional radiology and specialized
radiology
- Access to Chronic and HIV/AIDS Medicine Benefit
- Dental surgery and specialized dentistry
- Refractive Surgery
- Basic dentistry in hospital for children under the age of seven
- Services and treatment as indicated on each benefit option
How is pre-authorisation obtained?
Pre-authorisation is obtained by contacting the scheme on 3624700 or sending an email to
botsogo pre-authorisation@metropolitan.co.bw Please have your membership number at
hand.
Your service provider may also request pre-authorisation on your behalf
The service provider needs to provide the diagnosis, the intended treatment and estimated cost
in writing as verbal pre-authorisation will not be permitted. This is subject to assessment.
A pre-authorisation number will be issued for the specific event as listed above or indicated in
the benefit structure upon approval.
Failure to acquire pre-authorisation
If a member needs emergency treatment outside of working hours or on the weekend then pre-
authorisation can be requested on the next working day.
Claims submitted without pre-authorisation will be rejected whether the claim is payable to the
member or service provided.
Emergency Situations
What constitutes an emergency?
The onset of a sudden health condition at the time that is unexpected and requires immediate medical or surgical treatment and would result in serious impairment to bodily functions or serious dysfunctions of a bodily organ or part, or would place the person’s life in serious jeopardy and even result in death.
Procedure to be followed
Call the Emergency Service Providers directly or Botsogo Health Plan on +267 73014111 for
immediate paramedic assistance. Depending on the situation, proceed to your nearest
emergency medical facility/hospital