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  • Treating anal fissures and fistulas at Al Waha Hospital

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    Ibrahim Sabry Rehab
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    This document provides a summary of a patient's in-patient service at Al Waha Hospital. It includes the patient's information such as name, membership ID, attending doctor, ICD code for the diagnosis of fissure and fistula of the anal and rectal regions. It requests approval for a medical procedure with a financial limit of 5000 EGP for hemorrhoidectomy and excision of anal fissure. Any amount over this requires approval from the insurance company. The service was approved for 1 day of accommodation in a single room.

    Original Description:

    sky

    Original Title

    Sky - Ibrahim Sabry

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    This document provides a summary of a patient's in-patient service at Al Waha Hospital. It includes the patient's information such as name, membership ID, attending doctor, ICD code for the diagnosis of fissure and fistula of the anal and rectal regions. It requests approval for a medical procedure with a financial limit of 5000 EGP for hemorrhoidectomy and excision of anal fissure. Any amount over this requires approval from the insurance company. The service was approved for 1 day of accommodation in a single room.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views1 page

    Treating anal fissures and fistulas at Al Waha Hospital

    Uploaded by

    Ibrahim Sabry Rehab
    This document provides a summary of a patient's in-patient service at Al Waha Hospital. It includes the patient's information such as name, membership ID, attending doctor, ICD code for the diagnosis of fissure and fistula of the anal and rectal regions. It requests approval for a medical procedure with a financial limit of 5000 EGP for hemorrhoidectomy and excision of anal fissure. Any amount over this requires approval from the insurance company. The service was approved for 1 day of accommodation in a single room.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    Date : 05/09/2018

    Service Type: In-Patient


    Doctor : Eman_Mohamed Icd Code: K60.
    att./Provider : Al Waha Hospital - - ‫ﻋﻨﺎﻳﺔ‬/ ‫ﻣﻘﺪﻡ ﺍﻟﺨﺪﻣﺔ‬

    att/Client: Sky ‫ﻋﻨﺎﻳﺔ‬/ ‫ﺍﻟﻌﻤﻴﻞ‬

    Approval Number: 2415 Member Name : Ibrahim Sabry Abdel Kader Ali Eisawy Rehab
    Client Name : Sky
    Center Name : Al Waha Hospital Membership ID : 5800040571 Relation : Head Of Family
    Network Type: Network A Class: Staff
    Provider I :
    Provider II : Copayment 0 L.E
    Provider III :
    Validity : 7 Days only

    Chief Complaint
    Clinical Data 1- 2- 3-
    History 1- 2- 3-
    Diagnosis Fissure and fistula of anal and rectal regions

    Medical Procedure Name Request Approval

    In Case of Accomodation
    No. Of Days 1
    Extension
    Room Board Single Room
    Company Comment

    Provider Comment

    ‫ ﺟﻢ ﺧﻤﺴﺔ ﺍﻻﻑ ﺟﻢ ﻭﻣﺎ ﻳﺰﻳﺪ ﻋﻦ ﺫﻟﻚ ﺑﺮﺟﺎﺀ‬٥٠٠٠ ‫ﻋﻤﻠﻴﺔ ﺍﺳﺘﺌﺼﺎﻝ ﺑﻮﺍﺳﻴﺮ ﻭﺷﺮﺥ ﺷﺮﺟﻲ ﺍﻟﺤﺪ ﺍﻟﻤﺎﻟﻲ ﻟﻠﻌﻤﻴﻞ‬
    ‫ﺍﻟﺮﺟﻮﻉ ﻟﺮﻭﻳﺎﻝ‬
    Doctor Signature Approved By

    48947053092415

    DATE Wednesday-SEP-2018 11:26:49

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