Some Genki Native treatments and benefits require prior approval before the treatment or service is provided. You can request it directly through the Claims Center in your Member Center.
When is prior approval required?
Prior approval is required for the following treatments and benefits:
Second Medical Opinion – Basic & Premium
Home Nursing Care – Premium
Transportation to specific treatments, such as dialysis, radiation therapy, or chemotherapy – Basic & Premium
Psychiatry – Premium
Talk Therapy – Premium
Family Hospital Visits – Basic & Premium
Parent Beds for minors – Premium
For Alternative Care under Genki Native Premium, the treatment must be prescribed or receive prior approval.
How to request pre-approval
Log in to your Member Center and select "Compensation".
Select the subscription for which you want to submit the request.
Please click on "Request Compensation" button.
In the Claims Center, select "Confirmation of coverage".
Click "+ Create request".
Describe your medical condition and the proposed treatment or benefit.
Upload the relevant medical documentation from your doctor or hospital.
Click "Submit".
Important
If pre-approval is required, please submit it before receiving treatment or incurring costs.
If you do not request confirmation when it is required, your reimbursement request may be declined.
You do not need to submit a pre-approval request for an inpatient stay managed by Emergency Assistance, or when Emergency Assistance has already confirmed coverage for the treatment or benefit.