AUTHORISATION SERVICE
In order to streamline procedures and make matters easier for our insured, most medical treatments covered by our health insurance do not require prior authorization, which significantly reduces the number of medical benefits that need this procedure. Only the medical report or clinical note provided by the prescriber is required.
In addition, we have streamlined the authorization management process to make it more convenient, fast and efficient by applying Prescription Online, available for professionals from our Medical Center. This is a simple and fast procedure that, in no case, requires you to go to our offices.
You can contact the Medical Authorization Service through the following channels:
- APP Nueva Mutua Sanitaria, available on Google Play and the App Store
- Via the Private Login of the website
- E-mail: autorizaciones@nuevamutuasanitaria.es (monitored from Monday to Friday 8:00 a.m. to 8:00 p.m. (excluding bank holidays)
- Telephone: 912908075, Monday to Friday 8 a.m. to 8 p.m. (excluding bank holidays)
As a general rule, complex diagnostic tests, surgical procedures (with or without hospital admission), and hospital admissions require prior authorisation
When your doctor uses the online prescription system, they will inform you whether prior authorisation is required
Only the following medical services require prior authorisation:
HOSPITAL ADMISSIONS (Including day hospital admissions)
SURGICAL PROCEDURES
ONCOLOGY TREATMENTS
COMPLEX DIAGNOSTIC TESTS
- Genetic testing
- PET-CT and PET-MRI scans
- Nuclear Medicine tests
- Therapeutic target studies
- Video EEG monitoring
- Polysomnography (sleep studies)
- Coronary CT scan
- Infiltrations/injection therapies of any kind
- Any medical procedure involving the administration of medication on an outpatient basis or the implantation of prosthetic devices
COMPLEX THERAPEUTIC PROCEDURES
- Vascular, Cardiac and General Surgery: therapeutic varicose vein sclerotherapy (per session), pacemaker implantation, implantation of venous access ports for chemotherapy or dialysis
- Digestive System: gastrointestinal stent placement, endoscopic mucosal resection (EMR), and complex non-diagnostic endoscopic resections
- Cardiology: diagnostic and interventional haemodynamic procedures, electrophysiological studies and treatments, and all pacemaker implantations
- Multidisciplinary Specialties: therapeutic infiltrations/injection therapies
- Diagnosis and treatment of infertility
- Oxygen therapy (CPAP and BiPAP)
- Interventional radiology
- Rehabilitation: rehabilitation other than musculoskeletal rehabilitation, neurological rehabilitation, and pelvic floor rehabilitation
- Pain Management: all pain treatment procedures
- Urology: fusion prostate biopsy, cryosurgery, photovaporisation, hyperthermia, micro-ultrasound procedures, holmium laser treatment of the prostate, and intravesical instillations
In the General Conditions document that we send with your policy, you will find the services that require authorisation. In general, this applies to complex diagnostic tests, treatments and hospital admissions. Usually the consultant will tell you if the test requires prior authorisation. If in doubt contact customer services on 912908075.
Yes, always.
If the admission is an emergency, it can be authorised in the following 72 hours.
If it is scheduled, it must be authorised before it takes place. This saves a lot of time and ensures the process is more seamless.
You will need to provide your insurance card togethera with de medial prescription and doctor’s note which indicates the necessary data. In some cases, it is also required to provide the exact date and location where the test or service will be carried out, as in the case of hospital admissions, surgical operations and out-patient tests.
When requesting authorisation via the Private Login, it will be necessary to attach a photograph of the doctor’s note.
In most cases, simply call our customer care team at +34 91 290 80 75. Please have your insurance card and your doctor’s note ready when you call.
The doctors on our medical team must always give you a note from Nueva Mutua Sanitaria. Currently, if for any reason they do not have a note, they can write a prescription on their own stationery, stamp and sign it. However, in such cases, you will need to supply us with a photograph or scan of the document to autorizaciones@nuevamutuasanitaria.es. Once received, we can issue the authorisation.
You must also send us the name and insured number of the patient and a contact telephone number. You can submit these details in the secure Private Login portal on the website.
The sooner you can make this request, the better. 90% of authorisations can be dealt with in real-time via a telephone call. However, if there is any issue comes up or if details are missing, up to 48 hours may be needed for the issue of the authorisation number.
In foreign countries, our authorisations are not valid. The cover that we have in these cases is a travel assistance policy which covers accidents or illnesses arising during the trip. For further details contact our 24/7 helpline (+34) 91 290 80 78.
During the qualification period, you do not have access to the benefits which require authorisation. For this reason, we cannot authorise services until you have qualified for cover.
Usually this applies to benefits which have a limitation. The possible limitations are always reflected in the general conditions of your policy. The report must reflect a reason which is in line with the cover contracted for to authorise the benefit.
E-mail is the most secure and effective way: autorizaciones@nuevamutuasanitaria.es
Once your medical report has been submitted, you will receive a response to your authorisation request within 48 business hours.
Please note that medical prescriptions are valid for 60 days, while authorisations remain valid for 30 days.
No. All medical prescriptions are processed digitally, so every prescription must be issued electronically. As soon as your doctor generates the electronic prescription, the medical authorisation process is automatically initiated. Therefore, no referral form is required.
However, if you experience any problems or need assistance, you can contact the Medical Authorisations Service by calling +34 91 290 80 75, available Monday to Friday from 8:00 a.m. to 8:00 p.m., or by emailing autorizaciones.medicas@nuevamutuasanitaria.es.
It is advisable. From the moment that we issue an authorisation, it will be valid for of 30 days. If, for any reason, the conduct of the test or treatment is delayed, the authorisation may lapse. In these special circumstances you would have to reapply.