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The essential guide to your International Health Insurance

First Aid Kit
Medical Notification
& Authorization

Medical Notification & Authorization

What is a notification?*

It is the process by which the insured

informs the Insurance Company in advance about certain medical services they plan to receive.

A Notication is required for services that will be submitted via reimbursement without prior approval. It is essential to notify in order to:

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Confirm elegibility

Avoid unexpected penalties or higher out-of-pocket costs

Ensure that the claim does not incur a 30% penalty for lack of notication

When must a notification be made?

If the service will be submitted via reimbursement, the insured must notify:

Scheduled services

At least

72 hours

prior to the event

Emergencies

Within

48 hours

after the event

(by the insured or someone acting on their behalf)

What happens if you don’t notify?

If a Notication is not received within the required timeframe (unless the delay was beyond the insured’s control), the insured becomes responsible for

30% of all

Covered Expenses

including deductible and coinsurance

How is a notification submitted?

Notications must be submitted via the member or agent portal and must include the following:

  • Medical diagnosis / symptoms.
  • Medical records, as needed.
  • Hospital or facility information.
  • Date of service.
  • Doctor’s name.

What is an authorization?

It is the Insurance Company’s

formal approval confirming that a specific medical service or treatment is covered under the policy

Authorization is required for specialized or high-cost services as indicated in the Table of Benefits

When should you request an authorization?

You must obtain an Authorization before receiving any service or treatment that requires prior approval as indicated in the Table of Benefits

An Authorization must be requested at least 72 hours before a scheduled service, to ensure:

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The service is

covered

It is medically

necessary

The insured avoids delays, penalties, or claim denials

Which services require Authorization?

(when covered by the policy’s Table of Benefits)

  • Reconstructive nose surgery
  • Prophylactic surgery for reduction of cancer risk
  • Bariatric surgery, gastric bypass, and any other weight-loss procedures.
  • Advanced medical treatments related to:
  • Cancer.
  • Congenital conditions.
  • Hereditary conditions.
  • Organ and tissue transplants.
  • Emergency transportation by air ambulance.
  • Durable medical equipment or special devices.
  • Outpatient physical therapy, rehabilitation, and home health care.
  • Treatment for HIV and AIDS.
  • Palliative/hospice care for terminal conditions.
  • Repatriation of mortal remains or cremation services.
  • Deliveries within the Best Doctors Insurance Maternity Network.
  • Maternity Network.
  • Cochlear implants.

Additional services that must also be
coordinated by the Insurance Company:

  • Prophylactic surgery for reduction of cancer risk
  • Bariatric surgery, gastric bypass, and other weight-loss procedures
  • Advanced medical treatments related to cancer, congenital and hereditary conditions
  • Organ and tissue transplants
  • Emergency transportation by air ambulance.
  • Durable medical equipment or special devices.
  • Cochlear implants.

How is a request for authorization submitted?

Email precert@bestdoctorsinsurance.com or submit your request through the member portal including the following:

  • Medical diagnosis / symptoms
  • Documentation from your treating physician detailing onset of symptoms and treatment required
  • Relevant test results
  • Treatment plan details
  • Hospital or facility information
  • Date of service
  • Doctor’s name

Tip

Submit your authorization request at least

3-5

business days

prior to the scheduled event to avoid delays and ensure proper review.

Out-of-Network Care with Best Doctors Insurance

What you need to know
 Avoid costly penalties – Coordinate ahead

To ensure you receive the best coverage, please schedule your services at
hospitals within your plan’s network

Using a non-participating hospital may result in a

40% cost share

Coordinating your care with a participating hospital helps you avoid this additional expense

Plans with hospital restrictions

Important reminder

If you’re unsure whether a hospital is in your plan’s network, please contact us for confirmation — we’re here to help!

You can easily find the list of participating hospitals in the Member Portal.

Emergency care

You will always be covered for emergency care, even if it’s outside your plan’s network.

No 40% penalty applies
in these situations.

Do you know what the 3 main benefits are of paying the deductible in advance?

Peace of mind

Navigate and plan for financial challenges with greater certainty and confidence.

Get the treatment you need

With one less thing to worry about, you can focus on what matters most— your health.

Hassle-free access

Find out in the video how to do it in five easy steps

How to take advantage 
of this incentive?

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Send your request to precert@bestdoctorsinsurance.com

You will receive a confirmation
number

Use that number to make the payment through the Member Portal

Keep in mind

  • The incentive applies to preapproved services within the United States.
  • For services outside the U.S., deductible prepayment is limited and requires prior approval.
  • Only credit card payments are allowed.

What forms do I require for maternity, nursing care or physiotherapy service?

Simply follow these steps:

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Log into the Agent or Member Portal.

Download and fill out the corresponding notification forms.

Send the completed forms to: precert@bestdoctorsinsurance.com

Need help?

Email Customer Service at BDservice@bestdoctorsinsurance.com for individual policies BDGroupsService@bestdoctorsinsurance.com for corporate groups.



 

Always contact our team before seeking care outside the network precert@bestdoctorsinsurance.com