Who submits the surgery authorisation with Sanitas, the clinic or the patient?

Surgery and hospitalisation consistently appear as flows handled by the clinic with the insurer, not by the patient. Sanitas keeps its Provider Portal medicosblua.es as the main channel. The exact mandatory fields, validity window and attachment requirements per surgery subtype depend on the centre agreement and are not fully exposed in public sources.

What minimum documentation does a Sanitas surgical request need?

A scheduled surgery request is built on the clinical report justifying the intervention, the surgical procedure code, the ICD-10-ES diagnosis, the prescribing physician with identifier number, the proposed centre and the planned surgery date. When the request is incomplete, the insurer may return it for insufficient justification, wrong code or missing document.

How does SaludComply coordinate the authorisation with the surgical calendar?

In a clinic with its own theatre, a late authorisation is not only an invoice at risk: it is unused theatre time and a patient to reschedule. The agent works the request against the surgical calendar, watches status on the portal, renews if the date moves and links the authorisation number to the record so it later matches on the invoice. The admin approves every submission before it goes out to the portal.

Surgery authorisation with Sanitas: surgical calendar and clinical documentation

By Andrew Swiler · CEO, SaludComply

CEO of SaludComply. Works on authorization automation for Spanish private healthcare and how the main insurers’ provider portals (Adeslas, Sanitas, ASISA, DKV, MAPFRE) operate. Based in Barcelona.

What is verified about Sanitas surgery

Surgery and hospitalisation consistently appear as flows handled by the clinic with the insurer, not by the patient. Sanitas keeps its Provider Portal medicosblua.es as the main channel. Exact mandatory fields, validity windows and attachment requirements per surgery subtype depend on the centre agreement and are not fully exposed publicly.

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Minimum documentation for a surgical request

A scheduled surgery request is built on a clinical report justifying the intervention, surgical procedure code, ICD-10-ES diagnosis, prescribing physician identifier number, proposed centre and planned surgery date. When the request is incomplete, the insurer may return it for insufficient justification, wrong code or missing document. The denial taxonomy appears transversal across insurers.

Surgical calendar and cost of delay

In a clinic with its own operating theatre, a late authorisation is not only an invoice at risk. It is unused theatre time, an idle clinical team and a patient the admin must call to reschedule. The compounded cost of the delay far exceeds the nominal cost of the act. Surgery is, per economic unit, the procedure where the difference between a well-coordinated and a poorly-coordinated authorisation shows the most.

How SaludComply approaches it

For Sanitas surgery, SaludComply works the request against the surgical calendar rather than the general queue. The authorisation is requested with the lead time the clinic decides, status is watched on the portal, renewal is triggered if the date moves and the case is linked to the patient record with the authorisation number that will later appear on the invoice. Clinic admin approves every submission before it goes out.

Frequently asked questions

Who submits the surgery authorisation with Sanitas, the clinic or the patient?: Surgery and hospitalisation consistently appear as flows handled by the clinic with the insurer, not by the patient. Sanitas keeps its Provider Portal medicosblua.es as the main channel. The exact mandatory fields, validity window and attachment requirements per surgery subtype depend on the centre agreement and are not fully exposed in public sources.
What minimum documentation does a Sanitas surgical request need?: A scheduled surgery request is built on the clinical report justifying the intervention, the surgical procedure code, the ICD-10-ES diagnosis, the prescribing physician with identifier number, the proposed centre and the planned surgery date. When the request is incomplete, the insurer may return it for insufficient justification, wrong code or missing document.
How does SaludComply coordinate the authorisation with the surgical calendar?: In a clinic with its own theatre, a late authorisation is not only an invoice at risk: it is unused theatre time and a patient to reschedule. The agent works the request against the surgical calendar, watches status on the portal, renews if the date moves and links the authorisation number to the record so it later matches on the invoice. The admin approves every submission before it goes out to the portal.

Verified sources

Sanitas — sitio oficial — referencia pública del operador
SaludComply — diagnóstico de autorizaciones — diagnóstico de fuga por autorizaciones