Get Predetermination Approval Form - Metlife - Metlife

Filling out the Predetermination Approval Form is an essential step for users seeking medical treatment approval through MetLife. This guide provides a clear, step-by-step approach to ensure that you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to access the Predetermination Approval Form and open it in your editor.
2. Begin by completing the form in capital letters as instructed. Fill in the hospital or clinic name in the designated field.
3. Next, enter the physician's name and their contact number. It is important to ensure that this information is accurate for effective communication.
4. Proceed to fill in the date of the request. Use the format Day (D), Month (M), Year (Y).
5. Enter the patient's name and contact number in the respective fields. This information is crucial for identification and communication purposes.
6. Provide the policy number and certificate number, ensuring they are correct to avoid any processing delays.
7. Specify the main complaints and the duration of the condition in detail. This helps assess the necessity for treatment.
8. Indicate the onset of the present illness and include any relevant diagnosis information.
9. List the date of any previous treatment or consultation related to this disability, ensuring continuity of care.
10. Select the approval requested by checking the appropriate box for in-hospital admission, CT scan, MRI, outpatient surgery, physiotherapy, or other. Specify the type of surgery if applicable.
11. Estimate the number of days of hospitalization required and provide an estimated cost of treatment.
12. Review all provided information for accuracy. Once confirmed, save the changes to the form.
13. Lastly, download, print, or share the completed form as necessary for submission.

Complete your Predetermination Approval Form online today to ensure timely processing of your treatment request.