How to check if you will have a shortfall for an approved in-hospital procedure

Follow the simple steps below:

• Once your authorisation is approved, you may request that Libcare provides you with a comparative quote between what the treating provider will charge and what Libcare will fund for the procedure. The request must be submitted before your procedure is done.
• The quote request will help you to understand your cover and any shortfalls that you may have to pay from your own pocket.
• Please note that it takes up to 3 working days to complete the quote request.
• The quote is valid according to the codes received. If your doctor changes or adds codes to this quote, this quotation will not be valid for the claim in question.
• This is only a guideline for costs and what Libcare will pay according to available benefit, limits and scheme rules.
• Provide a separate rand value for each procedure code. We are unable to provide a comparison for estimated or combined amounts.
• Provide all the ICD-10 diagnosis codes and all the procedure and product codes. An ICD-10 code describes your diagnosis and a procedure describes the procedure/s that will be done.
• The information in a quote is confidential, so we will send the quote to you only. We will send the quote letter using the email address you provide on the form.
• If you have any questions in relation to the process, please contact our Contact Centre on 0800 12 CARE (2273) or email enquiries@libcare.co.za, Mondays to Fridays from 8:00 to 17:00 (excluding public holidays). Alternatively, you can access the website at www.libcare.co.za.