HomePrior authorizationResultFollow-up authorization
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Follow-up authorization

Follow-up authorization: ask for more services or days on an approved authorization.

Linked to

Earlier authorization
PA-10977, Approved
Linked by
NPHIES response ID 9e61b4d7-0a32-4c5f-8e29-d1f7a63b04c8
Patient
Noura Al Harbi
Payer
Bupa Arabia

Follow-up

Additional service

Service code and description Quantity Unit Price Net Amount Patient Share Payer Share
Inpatient room, semi-private (2 nights) 2 900.00 1,800.00 360.00 1,440.00
Follow-up authorization opens the same sections as New prior authorization. The care team, diagnoses and insurance are copied from PA-10977. Change them only if they are different.
CancelDraft saved 2 minutes agoSaved in RaneemHCP only. Nothing is sent to NPHIES until you submit the request.Save draftSubmit follow-up
Added. The new row appears in the list.
Draft saved. Nothing is sent to NPHIES.