Considered,
not complicated.

If your pre-authorisation relates to a hospital admission or procedure

Please have the following information available:

• Patient's name, date of birth and ID number
• Lion Health membership number
• Treating doctor's name, contact number and practice number
• Hospital or day clinic name, telephone number and practice number
• Planned admission or procedure date
• Diagnosis (ICD-10) code
• Procedure (CPT/tariff) codes supplied by your doctor

Please note: Pre-authorisation does not automatically guarantee payment. It confirms that your request has been assessed against your policy benefits and table of limits. Always keep your confirmation reference number or pre-authorisation letter for your records.

How to submit a claim

• Submit to Admin: Email all documents to claims@pamc.co.za (administered by Pan-African Managed Care - PAM)
• Specialist Claims: If you are claiming for a specialist, ensure you include a Specialist Referral Form completed by your designated network doctor, as their network partners must manage all out-of-hospital referrals
• Processing Time: Standard expense claims and refunds typically take between 5 to 14 days to be assessed, approved, and processed
• Deadlines: Ensure you submit your claim within four months of the treatment date; claims submitted after this period become "stale" and are generally rejected
• Support: For immediate queries, you can reach the Lion Health claims and support line directly at 087 943 9612