Frequently Asked Questions

WHAT SHOULD I DO IN EMERGENCY CASES?

In case of emergency go to the nearest hospital within the medical network.

In case of emergency, go to the nearest hospital within our medical network. All required services will be done instantly without any delay, and you can have direct access to an emergency room with just your Membership card! In case of hospitalization/ operation required we’ll handle any approval requests for you quickly- all thanks to our approvals team & call center who are always there for your help. If need anything more or want support in general, then feel free contact us on +202 19736

Interested in finding a medical provider?

Medical providers are just a click away with the use of our mobile application or our website. Search for your preferred location and filter by medical type to find what you’re looking for!

Medical services that require prior approvals

We do not allow any hospitalization, surgical operations or physiotherapy sessions without prior approval from Wadi El Neel. For all other imaging services such as MRI and CT scan you are required to get a referral letter before your visit for pre-approval

Medical Approval Expected Duration?

In order to receive approval from a provider, send your request with the name of the service you wish to perform at their location through:

  • Emailing hline@lotus-global.com (or use our mobile app)
  • Calling +202 19736 or calling into our call center (+202 19736). It takes only 30 minutes maximum for feedback!

It is mandatory for applicants to be a member and provide their membership card. Applicants will also need to fill out the required claim form which includes what service they wish to receive, as well as any medical diagnosis that can contribute towards proving the legitimacy of this request. All claims are screened by our team before approval if there’s no clear medical report then these steps above may not apply in some cases depending on how you plan on submitting your application

Documents required for approvals.

It is mandatory for applicants to be a member and provide their membership card. Applicants will also need to fill out the required claim form which includes what service they wish to receive, as well as any medical diagnosis that can contribute towards proving the legitimacy of this request. All claims are screened by our team before approval if there’s no clear medical report then these steps above may not apply in some cases depending on how you plan on submitting your application

WHY DO SOME SERVICES REQUIRE MEDICAL APPROVAL?

Prior approval is a procedure which ensures that the best, most appropriate healthcare for you will be offered. Services such as medical procedures and dental treatments may need your doctor’s go-ahead before they can proceed with treatment on your behalf. The purpose of prior approvals is to ensure:

  • The beneficiary has received all recommended care in line with their case status; this means not only current interventions but also any future ones needed at each stage along the way (including curative or palliative).
  • This service meets the requirements set by Wadi El Neel’s health plan coverage – meaning it falls under our list of services covered within an annual limit amount per member.

If you're visiting a medical provider outside your coverage network, how can you apply for reimbursement?

You should submit the following documents:

  • The original physician’s prescription.
  • A detailed medical report. Copy of all investigations and laboratory test results (in cases of hospitalization or surgical operations); Original invoices and receipts for all procedures done (signed and stamped officially). Preauthorization approval from Wadi El Neel where applicable. All claims should be submitted together with these necessary documents within 90 days from treatment date.
  • Our team is always here for you to help with anything, and our goal is to provide a fast, easy, and comfortable experience.
  • We hope you find these answers helpful. However, we want to make sure that your questions are answered right away so please feel free to contact us at any time!

In case of emergency, go to the nearest hospital within our medical network. All required services will be done instantly without any delay and you can have direct access to an emergency room with just your Membership card! In case of hospitalization/ operation required we’ll handle any approval requests for you quickly- all thanks to our approvals team & call center who are always there for your help. If need anything more or want support in general then feel free contact us on +202 19736

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