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Authorisations & motivations

Authorisations managed. Requirements tracked.

HealthAdmin supports the administrative and funding process around clinical motivations. Authorisation applications are document-heavy and deadline-bound, and they are the first thing to slip when a practice is busy — a procedure date does not move because the administrative requirements were not completed in time.

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You will recognise some of these.

  • Authorisation applications are sitting unsubmitted while a procedure date approaches
  • Clinical motivations and supporting documentation are delayed because urgent patient and practice priorities come first
  • Nobody is tracking which applications have been answered and which have not
  • Scheme requests for further information are arriving faster than they can be answered

What this covers

The work itself

  1. Preparing the application

    Compiling the authorisation application in the form the scheme requires, with the supporting documentation attached before it goes out.

  2. Coordinating supporting documentation

    Assembling the administrative and funding documentation that has to accompany a clinical motivation. The clinical rationale is written by the treating practitioner; HealthAdmin does not create clinical justification.

  3. Submitting on your instruction

    Lodging applications and motivations with the scheme under an agreed written mandate.

  4. Tracking to an answer

    Following the application through, responding to requests for further information, and recording the outcome in writing.

  5. Keeping the practice informed

    Telling you what is outstanding and what is waiting on a clinical decision, before it becomes urgent.

Responsibility

Where the line sits

HealthAdmin supports the administrative and funding process around clinical motivations. It does not create clinical justification.

The treating practitioner provides

  • Diagnosis
  • Clinical judgement
  • Treatment decision
  • Clinical rationale
  • Clinical motivation content

HealthAdmin manages

  • Administrative requirements
  • Documentation coordination
  • Submission
  • Tracking
  • Medical scheme correspondence
  • Follow-up
  • Requests for additional information
  • Appropriate administrative escalation

Where this stops

Diagnosis, clinical judgement, treatment decisions, clinical rationale and the content of any clinical motivation remain entirely with the treating practitioner. HealthAdmin assists with the administrative and funding requirements around them: documentation coordination, submission, tracking, scheme correspondence, requests for further information and escalation administration. Authorisation decisions are made by the medical scheme.

Questions practices ask first.

Do you write the clinical motivation itself?

No. The clinical rationale is written by the treating practitioner. HealthAdmin supports the administrative and funding process around it, assembles what the scheme requires and gets it submitted and tracked.

How quickly can an urgent authorisation be handled?

That depends on current capacity and on the scheme's own turnaround. Raise the timeline on the call and you will get a straight answer about what is realistic.

Can you guarantee an authorisation?

No. Authorisation is the scheme's decision. HealthAdmin makes sure the application is complete, submitted and followed up.

Read more on this

The rest of what HealthAdmin handles

All services

Remote support for practices across all nine provinces. Call 084 301 6520.

Where is your practice losing time or revenue?

Tell us where the administrative pressure sits. PMBs, claims, authorisations, scheme queries, or a backlog nobody has time to work.

Book a Practice Assessment084 301 6520

Please do not submit patient medical information through this website.

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