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    25960641-OE22102263997

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    25960641-OE22102263997

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    6 views2 pages

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    6 views2 pages

    25960641-OE22102263997

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    Pre-authorisation reference A17842806

    22 October 2022 • P 1 / 2

    Ms Naya Mohamed Moemen Mohamed Helal Bupa Egypt Insurance


    Egypt Bldg 3/B1, Mivida Business Park
    5th Settlement
    New Cairo
    11835
    Egypt

    T: +44 (0) 1273 333 911


    F: +44 (0) 1273 866 301
    Egyptcustserv@bupa-intl.com
    29229653 www.bupaglobal.com

    Your pre-authorisation request has been approved.

    Please note treatment must be within the terms and conditions of your health plan and
    settlement of eligible costs is subject to an active health plan at time of treatment and
    available benefit(s) at point of claim. If treatment is for any pre-existing condition that was
    required to be disclosed to us prior to joining the health plan, it will not be covered. For full
    details of what is covered by your health plan including any limitations, exclusions, waiting
    periods, co-insurances or deductibles, please refer to your membership guide and insurance
    certificate. You can find these on the MembersWorld app or online at:
    membersworld.bupaglobal.com.

    Pre-authorisation A17842806 for treatment at Yodawy (659819)


    Patient details

    Name Naya Mohamed Moemen Mohamed Helal

    Policy number BI-6000-0301-4515

    Diagnosis/condition Upper Resp.Infection/Multiple Unspec.Sites-Acute (465.00)

    Symptoms throat infection

    Treatment details

    Consultant na

    Treatment/procedure Prescribed Drugs and Dressings (PD001)


    Decancet SR, Deltarhino, Immunomash, dolo gel, levohistam,
    Maxilase

    Treatment date 22/10/2022

    Sessions approved 0

    Country Egypt

    ###############################################################

    This pre-authorisation is valid for 31 days and includes any relevant tests and follow up
    consultations with the same specialist.

    The out-patient benefit is paid as follows per membership year:

    BUPA EGYPT INSURANCE SAE, a company incorporated in Egypt (Commercial ،)67829 :‫ هي شركة تأسست في مصر (سجل تجاري رقم‬،‫م‬.‫م‬.‫بوبا إيجيبت للتأمين ش‬
    Registry No: 67829) whose head office and legal domicile is at Bldg 3/B1, ،‫ مجمع ميفيدا التجاري‬،1‫ ب‬/ 3 ‫ويقع مقرها الرئيسي ومحلها القانوني في مبنى رقم‬
    Mivida Business Park, 5th Settlement, New Cairo, 11835, Egypt, with issued capital ‫ مليون‬60 ‫ برأس مال مصدر‬،‫ مصر‬،11835 ‫ رقم بريدي‬،‫ القاهرة الجديدة‬،‫التجمع الخامس‬
    of EGP 60 million. Bupa Egypt Insurance SAE is regulated under law no. 10 for year
    1981 and its executive regulations holds Financial Regulatory Authority (FRA) license ‫ والئحته‬1981 ‫ لسنة‬10 ‫م لقانون رقم‬.‫م‬.‫ تخضع بوبا إيجيبت للتأمين ش‬.‫جنيه مصري‬
    under number 20 for year 2004. .2004 ‫ لسنة‬20 ‫ كما تحمل ترخيص الهيئة العامة للرقابة المالية برقم‬،‫التنفيذية‬
    EGY-PAPP-SWN-STND-CYAN-A4-XXXX-2110
    Pre-authorisation reference A17842806
    22 October 2022 • P 2/2

    - up to [ USD 15,000 with USD 14,997.20 remaining ] for out-patient consultations with a
    specialist
    - up to [ USD 15,000 with USD 14,997.20 remaining] for pathology, x-rays and diagnostic
    tests
    - up to [ USD 15,000 with USD 14,997.20 remaining] for prescribed drugs and dressings with
    a 20% co-insurance

    - MRI / CT / PET scans are covered in full

    IMPORTANT: Please note that the benefit limits detailed here are subject to any paid claims
    and therefore may not be available in full by the time the claim is received

    ###############################################################
    Eligible treatment shall be limited to the reasonable and customary charges in the
    area or country in which the treatment is provided. Charges over reasonable and
    customary will not be paid and may result in a shortfall.

    What to do next
    1. Please read the pre-authorisation details and make sure they are correct. If you need to
    make any changes please contact us before treatment:
    • Using our messaging service through MembersWorld at
    membersworld.bupaglobal.com. This is the quickest and easiest way to contact us.
    • Phone: Please use the number on your membership card
    • Email: Egyptcustserv@bupa-intl.com
    2. Once you have received the treatment, you can submit your claim via MembersWorld
    app and online at: membersworld.bupaglobal.com. Your MembersWorld account gives
    you access to Bupa Global’s digital services so you can manage your account online, get
    24/7 access to a doctor and contact us quickly for anything else you need using our
    messaging service.
    3. Please have the following information ready before submitting your claim:
    • Your detailed itemised invoice, including any relevant prescriptions for drugs and
    dressings or glasses
    • Your diagnosis and a description and cost of each treatment provided
    • Details of your medical practitioner, including their qualifications
    • Payment details

    BUPA EGYPT INSURANCE SAE, a company incorporated in Egypt (Commercial ،)67829 :‫ هي شركة تأسست في مصر (سجل تجاري رقم‬،‫م‬.‫م‬.‫بوبا إيجيبت للتأمين ش‬
    Registry No: 67829) whose head office and legal domicile is at Bldg 3/B1, ،‫ مجمع ميفيدا التجاري‬،1‫ ب‬/ 3 ‫ويقع مقرها الرئيسي ومحلها القانوني في مبنى رقم‬
    Mivida Business Park, 5th Settlement, New Cairo, 11835, Egypt, with issued capital ‫ مليون‬60 ‫ برأس مال مصدر‬،‫ مصر‬،11835 ‫ رقم بريدي‬،‫ القاهرة الجديدة‬،‫التجمع الخامس‬
    of EGP 60 million. Bupa Egypt Insurance SAE is regulated under law no. 10 for year
    1981 and its executive regulations holds Financial Regulatory Authority (FRA) license ‫ والئحته‬1981 ‫ لسنة‬10 ‫م لقانون رقم‬.‫م‬.‫ تخضع بوبا إيجيبت للتأمين ش‬.‫جنيه مصري‬
    under number 20 for year 2004. .2004 ‫ لسنة‬20 ‫ كما تحمل ترخيص الهيئة العامة للرقابة المالية برقم‬،‫التنفيذية‬
    EGY-PAPP-SWN-STND-CYAN-A4-XXXX-2110

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