Which tests need authorization with Adeslas?

The general private-insurance pattern is that high-cost or high-coordination acts —surgery, hospital admission, complex diagnostic imaging such as MRI, CT or PET-CT, rehabilitation in blocks, psychotherapy and oncology— usually require prior authorization, and Adeslas fits that pattern. The exact list varies by insurer and policy, so it should be confirmed with Adeslas for each act, without assuming a specific rule unverified. The agent classifies the act and, when in doubt, asks for human validation before starting the workflow.

Do MRI or PET-CT need authorization with Adeslas?

In the private sector, MRI and PET-CT usually fall into the group of tests requiring prior authorization due to their cost and coordination. Whether one of these tests needs authorization with Adeslas must be confirmed for that specific policy: no specific Adeslas rule is assumed without verifying it in the documentation or with the company. The prudent approach is to treat these tests as authorization candidates by default and check coverage before booking.

How long does an Adeslas authorization last?

Adeslas publishes that, for most services, the authorization expires 30 calendar days from the date indicated on the request, unless the document specifies another term. For the clinic, the appointment date and the authorization date must be looked at together: a valid authorization used outside that window usually ends in a disputed invoice. The agent flags pending authorizations before they expire.

What happens if an Adeslas authorization expires?

If the procedure is performed outside the 30-day window, the authorization no longer covers the act and the invoice is at risk of dispute. In that case, the clinic should review the applicable channel and resubmit the request according to its agreement with Adeslas. SaludComply controls authorizations by status, appointment and expiry, prioritizes those worth renewing before they lapse, and holds every resubmission for human approval.

Which procedures need prior authorization with Adeslas: a guide for clinics

In private insurance, high-cost or high-coordination procedures —surgery, hospital admission, complex diagnostic imaging such as MRI, CT or PET-CT, rehabilitation in session blocks, psychotherapy and oncology— usually require prior authorization, and Adeslas is no exception to that general pattern. However, the exact list varies by insurer and policy, so a specific Adeslas rule for an act should not be assumed without verifying it in the policy document or with the company. Adeslas does publish that, for most services, the authorization expires 30 calendar days from the date indicated on the request.

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.

Which procedures need prior authorization with Adeslas?

The general pattern in private health insurance is clear: high-cost or high-coordination acts usually require prior authorization. That includes surgery and ambulatory surgery, hospital admission, complex diagnostic imaging such as MRI, CT or PET-CT, rehabilitation and physiotherapy in session blocks, psychotherapy, oncology and special treatments. Adeslas, as a private insurer, fits this pattern, but the exact list varies by insurer and policy. So it should be confirmed with Adeslas for each act, without assuming a specific Adeslas rule unverified: public documentation does not allow stating as fact that a given test does or does not require authorization with Adeslas. The prudent step for the clinic is to classify each scheduled act and check it against the policy before confirming an appointment.

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Diagnostic imaging: MRI, CT and PET-CT

Complex diagnostic imaging is the most consulted point and also the most disputed. In the private sector, MRI, CT and PET-CT usually fall into the group of tests requiring prior authorization, but whether a specific test needs authorization with Adeslas must be confirmed for that policy: no specific Adeslas rule is assumed unverified. Operationally, a clinic should treat these tests as authorization candidates by default, check coverage before booking and track request, status, authorization number and test date. An MRI or PET-CT performed without confirmed authorization usually ends in a disputed invoice.

How long an Adeslas authorization lasts and what happens if it expires

Adeslas publishes that, for most services, the authorization expires 30 calendar days from the date indicated on the request. This is one of the few facts that can be stated as a rule published by Adeslas. For the clinic it means the appointment date and the authorization date must be looked at together: an authorization approved on time but used outside the window usually becomes a disputed invoice. If the procedure is delayed beyond that window, the applicable channel should be reviewed and the request resubmitted according to the agreement with Adeslas. The queue should show what expires this week, not what someone remembers.

Per-procedure Adeslas guides

This guide is the starting point; each procedure has its own Adeslas guide. The MRI authorization guide covers diagnostic imaging, where clinical documentation matters most. The surgery authorization guide is the most sensitive case: approval must be in place before booking surgical capacity. The rehabilitation authorization guide explains that the risk sits in session-block renewals. The chemotherapy authorization guide covers oncology cycles and special treatments. The psychotherapy authorization guide gathers mental-health conditions. And the general Adeslas prior authorization guide for clinics brings together validity, documents and tracking. You will find the link to each in the related guides at the foot of this page.

How SaludComply handles it

SaludComply does not invent Adeslas rules or assume which test needs authorization without verifying it. It starts by measuring: how many Adeslas authorizations the clinic has per month by type of act, how many are denied, how many expire within the 30 days and how many are approved but unbilled. From there, the agent prepares the record documentation, checks known rules, reviews the cross-insurer denial reasons —missing document, wrong procedure code, weak clinical justification, procedure outside coverage and agreed-tariff mismatch— and holds every action for human approval before any submission. The natural starting point is the authorization diagnostic at /diagnostico-autorizaciones, which measures the clinic’s real volume before promising any specific workflow.

Frequently asked questions

Which tests need authorization with Adeslas?: The general private-insurance pattern is that high-cost or high-coordination acts —surgery, hospital admission, complex diagnostic imaging such as MRI, CT or PET-CT, rehabilitation in blocks, psychotherapy and oncology— usually require prior authorization, and Adeslas fits that pattern. The exact list varies by insurer and policy, so it should be confirmed with Adeslas for each act, without assuming a specific rule unverified. The agent classifies the act and, when in doubt, asks for human validation before starting the workflow.
Do MRI or PET-CT need authorization with Adeslas?: In the private sector, MRI and PET-CT usually fall into the group of tests requiring prior authorization due to their cost and coordination. Whether one of these tests needs authorization with Adeslas must be confirmed for that specific policy: no specific Adeslas rule is assumed without verifying it in the documentation or with the company. The prudent approach is to treat these tests as authorization candidates by default and check coverage before booking.
How long does an Adeslas authorization last?: Adeslas publishes that, for most services, the authorization expires 30 calendar days from the date indicated on the request, unless the document specifies another term. For the clinic, the appointment date and the authorization date must be looked at together: a valid authorization used outside that window usually ends in a disputed invoice. The agent flags pending authorizations before they expire.
What happens if an Adeslas authorization expires?: If the procedure is performed outside the 30-day window, the authorization no longer covers the act and the invoice is at risk of dispute. In that case, the clinic should review the applicable channel and resubmit the request according to its agreement with Adeslas. SaludComply controls authorizations by status, appointment and expiry, prioritizes those worth renewing before they lapse, and holds every resubmission for human approval.

Verified sources

Adeslas — Autorizaciones — fuente oficial: proceso de autorización y caducidad general de 30 días
DGSFP — Memoria del Servicio de Reclamaciones 2024 — contexto regulatorio sobre rechazo del siniestro y motivos de denegación