The prescribing doctor is outside the network: who starts prior authorisation?

Read the relevant distinction

Generali Tranquilidade’s FAQs distinguish the procedure for treatment prescribed by network and outside-network doctors, identifying channels for the insured person to request prior authorisation in the latter case. This is product guidance to be checked against your own policy, procedure and provider.

Sources: Generali Tranquilidade — Perguntas frequentes, pré-autorizações ↗

A fictional example

Fictional example: Ana receives a planned-treatment recommendation from a doctor outside the network. Rather than assuming the clinic has handled insurance, she asks who should start the process and which reference allows tracking. She keeps request submitted separate from response received. The illustration neither assesses clinical need nor confirms funding for treatment.

Prepare an answerable enquiry

Check the current process through your insurer’s official channel, including required information and how to obtain status. Do not post clinical documents publicly or send them to unverified recipients. Keep the reference and seek clarification if an administrative response is missing. These steps concern organising planned care; they do not replace medical assessment and should not delay assistance in an urgent situation. Record what remains pending without treating silence as approval.

Discuss the insurance need

On rmachado.group select Saúde and explain this question to prepare an insurance review. An enquiry does not confirm acceptance or cover. Share personal documents only through the indicated appropriate channel.