Pre-Approval Guidelines
Pre-approval ensures your treatment is covered under your Watania Takaful plan and complies with Sharia principles. This guide explains the pre-authorization process managed through NAS Neuron.
Services Requiring Pre-Approval
Mandatory Pre-Approval Services:
- All hospital admissions (planned and emergency within 48 hours)
- Day surgery and surgical procedures
- Cancer treatment (chemotherapy, radiation)
- Dialysis and kidney treatments
- MRI, CT, and PET scans
- Organ or tissue transplants
- Home healthcare services
- Alternative medicine treatments
Sharia-Specific Approvals:
- Cosmetic procedures (must be medically necessary)
- Mental health treatments (Islamic counseling available)
- Fertility treatments (within Islamic guidelines)
- Gender-specific doctor requests
- Prophetic medicine treatments
Approval Timelines by Plan
| Service Type | Basic Takaful | Standard Takaful | Comprehensive Takaful |
|---|---|---|---|
| Emergency Admission | 48 hours | 48 hours | 48 hours |
| Elective Surgery | 24-48 hours | 12-24 hours | 2-4 hours |
| Diagnostic Tests | 6-8 hours | 4-6 hours | 2 hours |
| Maternity Services | Not covered | 24 hours | Same day |
| Alternative Medicine | Not covered | 24 hours | 4 hours |
Pre-Approval Request Methods
1. Provider Direct Request (Recommended)
- Healthcare provider contacts NAS Neuron directly
- Provider submits medical reports and treatment plan
- Sharia compliance review conducted if needed
- Approval issued with Takaful reference number
- SMS sent to member with approval details
2. Member Portal/App Request
- Log into myNeuron app
- Select "Request Pre-Approval"
- Choose service type and provider
- Upload prescription and medical documents
- Submit and track status online
3. Call Center Request
- Call Neuron 24/7: 800-4408
- Provide member ID and treatment details
- Email supporting documents to approvals@neuron.ae
- Receive reference number for tracking
Required Documentation
Standard Medical Documents:
- Valid prescription from licensed physician
- Medical report with diagnosis
- Treatment plan with cost estimate
- Previous test results (if applicable)
- Provider license and details
Additional for Sharia Review:
- Medical necessity justification for cosmetic procedures
- Counselor credentials for mental health
- Fertility treatment protocol details
- Alternative medicine practitioner certification
Sharia Compliance Review Process
Certain treatments undergo Sharia review to ensure compliance:
- Initial Medical Review: Medical necessity established
- Sharia Board Assessment: Treatment method reviewed
- Alternative Options: Sharia-compliant alternatives suggested if needed
- Final Approval: Issued with any specific conditions
Special Considerations
Emergency Situations
- Life-threatening emergencies: Proceed with treatment immediately
- Provider can obtain verbal approval during emergency
- Formal approval must be submitted within 48 hours
- Emergency definition includes risk to life or permanent disability
Gender Preference Requests
- Specify preference when requesting approval
- Standard/Comprehensive plans prioritize gender matching
- Alternative providers suggested if preference unavailable
- Emergency care exempted from gender matching
International Treatment Approvals
- Comprehensive plan: Global pre-approval available
- Submit request 7 days before travel if planned
- Include treatment facility details and cost estimates
- Currency conversion at prevailing rates
Approval Validity and Extensions
| Approval Type | Validity Period | Extension Process |
|---|---|---|
| Standard procedures | 14 days | Request 48 hours before expiry |
| Chronic treatments | Up to 6 months | Review required for extension |
| Maternity | Full pregnancy term | Auto-extended for complications |
| Emergency | Initial 48 hours | Daily review until stable |
Common Rejection Reasons
- Service not covered under Takaful plan
- Annual or sub-limits exhausted
- Waiting period not completed
- Treatment not medically necessary
- Non-compliance with Sharia principles
- Incomplete documentation
- Provider not in network
Appeals Process
If pre-approval is rejected:
- Request detailed rejection reason and Sharia ruling if applicable
- Obtain additional medical documentation or second opinion
- Submit appeal within 7 days to appeals@neuron.ae
- Sharia Board review available for religious matters
- Final decision within 5 working days
Tips for Smooth Approvals
- Submit complete documentation first time
- Ensure provider is in your plan's network
- Check remaining annual limits before major procedures
- Request approvals during working hours for faster response
- For recurring treatments, request long-term approval
- Specify any religious preferences upfront