Pre-Authorisation Requirements
Malcor Plan D - no benefit for crown & bridge (and associated laboratory costs).
Malcor Plan D - No benefit available for implants.
Malcor Plan D - No benefit for Orthodontics and associated laboratory costs.
Malcor Plan D - no benefit for periodontal treatment.
Malcor Plan D - PMB admissions only.
The following are required for in-hospital pre-authorisations:
- Hospital practice number
- Anaesthetist practice number
- Treating clinician
- Hospital admission date
- Procedure code(s) with ICD-10 code(s) and where relevant the applicable tooth numbers
- If applicable, medical report of special medical conditions
- A medical report to clinically substantiate a medical condition that warrants general anaesthetics
- Clear X-rays of the impacted teeth are required
Note:
- All hospital cases are assessed individually.
- Further clinical information may be requested to support an authorisation request.
Email: hospitalenq@denis.co.za
Post: Private Bag X1, Century City, 7446
Malcor Plan D - benefit for moderate/deep sedation in the rooms limited to extensive dental treatment.
The following are required for moderate/deep sedation pre-authorisations:
- Anaesthetist practice number
- Treating clinician
- Proposed treatment date
- Procedure code(s) with ICD-10 code(s) and where relevant the applicable tooth numbers
- If applicable, medical report of special medical conditions
- Clear X-rays of the impacted teeth are required
Note:
- All sedation cases are assessed individually.
- Further clinical information may be requested to support an authorisation request.
Email: hospitalenq@denis.co.za
Post: Private Bag X1, Century City, 7446
Malcor Plan D - benefit available for one set of plastic dentures per beneficiary in a 4-year period.
The following are required for plastic denture pre-authorisations:
- For partial dentures, the missing tooth numbers
- For full dentures, an indication of the applicable jaw
Tel: 0861 033 647
Email: customercare@denis.co.za
Post: Private Bag X1, Century City, 7446