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When Should I Request LUMA’s Pre-Approval?

Pre-Authorization for Treatment

Pre-authorization ensures that your upcoming treatment is reviewed against your policy coverage before it takes place. If your treatment is covered, LUMA will issue a Letter of Guarantee (LOG) to the hospital, enabling direct billing—so you don’t have to pay out of pocket and wait for reimbursement. This also helps minimize delays, especially at discharge. 

 

How to Request a Pre-Approval 

  • If You’ve Scheduled a Treatment (Planned Admission) 
     Please inform the hospital in advance and ask them to submit a pre-authorization request to LUMA. This is the fastest and most effective way to initiate the process, as in-network hospitals are familiar with the procedure. 

  • If You’re Admitted Urgently (Emergency/Urgent Admission) 
     Ask the hospital to contact LUMA within 24 hours of admission to initiate pre-authorization. Prompt communication is key to securing direct billing coverage. 

 

Why Is Pre-Authorization Important? 

  • It allows us to confirm your policy eligibility in advance. 
  • It activates direct billing, meaning you won’t need to pay first (for covered conditions). 
  • It helps avoid discharge delays caused by missing approvals. 
  • It reduces the risk of being asked to pay upfront and submit claims later. 

 

Which Treatments Require Pre-Authorization? 

We recommend informing us in advance for the following: 

  • Hospital admissions (especially for elective surgeries) 
  • Outpatient procedures or daycare treatments 
  • Doctor visits related to vaccinations or chronic care 
  • Medical transportation 

Whenever possible, contact our Customer Service team at least two weeks before your hospital visit or scheduled surgery. 
In emergency situations, the hospital must notify LUMA within 24 hours of your admission. 

For certain elective or complex treatments, a Second Medical Opinion is strongly recommended. This helps ensure that the treatment plan is necessary and appropriate, giving you added confidence in your care decisions.