A prior authorisation from the CNS for a transfer abroad is mandatory in the following situations:
- the insured person is expected to stay for at least one night in a hospital abroad for scheduled care,
- the insured person's scheduled care involves the use of highly specialised and cost-intensive infrastructures, such as national competence centres, national services and specialised establishments of re-education, recovery (convalescence) and thermal cures,
- the insured person's scheduled care involves the use of highly specialised and cost-intensive equipments, as provided for in the national hospital plan.
In these cases, the doctor has to fill out a request for a prior authorisation of a transfer abroad.
How to request prior authorisation of a transfer abroad?
The request must be made well before the scheduled treatment is supposed to begin. This is made using a standard form "Request for prior authorisation of a transfer abroad" (available in French or German) which has to be completed by a doctor.
The request must be filled out in accordance with the dispositions of article 27 of the CNS statutes, thus, it is - among other things - essential to indicate the code CIM10 (ICD10) which the doctor can find under http://apps.who.int/classifications/icd10/browse/2008/en.
The request can then be submitted to the CNS by post, fax or email.
In order to process the request for prior authorisation of a transfer abroad efficiently, it is important:
- that the corresponding requests are submitted to the CNS in a timely manner. The request and the authorisation from the CMSS must be issued prior to the beginning of the treatment for which the transfer is requested,
- that the means of transport needed for the transfer abroad is indicated on the standard request form.