Pre-Approval Guidelines
Pre-approval (also called pre-authorization) is required for certain medical services to ensure coverage under your Al Wathba insurance plan. This guide explains when and how to obtain approvals through NAS Neuron.
Services Requiring Pre-Approval
Always Require Pre-Approval:
- All hospital admissions (planned and emergency)
- Day surgery procedures
- Chemotherapy and radiation therapy
- Dialysis treatment
- Home healthcare services
- Medical equipment (wheelchairs, oxygen, etc.)
Outpatient Services Requiring Approval:
- MRI and CT scans
- Physiotherapy sessions
- Speech therapy
- Mental health consultations
- Dental procedures exceeding AED 1,000
- All maternity-related services
Approval Timelines
| Service Type | Standard Timeline | Premium Plan Timeline |
|---|---|---|
| Emergency Admission | Within 48 hours of admission | Within 48 hours of admission |
| Elective Surgery | 24-48 hours | 2-4 hours |
| Diagnostic Tests | 4-6 hours | 2 hours |
| Physiotherapy | 24 hours | Same day |
How to Request Pre-Approval
Option 1: Provider Initiated
- Your healthcare provider contacts NAS directly
- Provider submits medical reports and treatment plan
- NAS reviews and issues approval reference number
- You receive SMS confirmation with approval details
Option 2: Member Portal/App
- Log into myNAS app or web portal
- Select "Request Pre-Approval"
- Upload prescription and medical reports
- Submit request and track status online
Option 3: Call Center
- Call NAS 24/7 helpline: 800-2311
- Provide member ID and treatment details
- Follow up with required documents via email
Required Documents
Ensure faster approval by providing complete documentation:
- Valid prescription from licensed physician
- Medical reports supporting the treatment
- Previous test results (if applicable)
- Cost estimate from provider
- Discharge summary (for readmissions)
Approval Validity
- Standard approvals: Valid for 14 days
- Chronic treatments: Valid for specified period (up to 6 months)
- Emergency approvals: Valid for initial 48 hours, then requires extension
Important Guidelines
Emergency Situations
In life-threatening emergencies:
- Seek immediate medical care first
- Provider can obtain verbal approval
- Formal approval must be submitted within 48 hours
- Keep all receipts if direct billing isn't possible
Approval Rejections
Common reasons for rejection:
- Service not covered under your plan
- Annual limit exhausted
- Incomplete documentation
- Treatment deemed not medically necessary
- Waiting period not completed
Appeals Process
If your pre-approval is rejected:
- Request detailed rejection reason from NAS
- Obtain additional medical documentation
- Submit appeal within 7 days
- Contact Al Wathba directly if needed: +971 600 544040
Tips for Smooth Approvals
- Submit requests during working hours for faster processing
- Ensure all documents are clear and legible
- Include contact numbers for urgent cases
- Check your remaining annual limit before major procedures
- For recurring treatments, request long-term approval
Remember: Pre-approval doesn't guarantee payment if the service is later found to be excluded or if fraudulent information was provided.