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

The exact requirement varies by policy and procedure. Adeslas currently publishes 90-day validity for medical tests, analyses, rehabilitation and psychotherapy. Admissions and interventions require an exact date and a new request if it changes. The issued authorization governs each case.

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.

Calculate revenue lost to authorisations

Use the SaludComply authorisation diagnostic to estimate monthly loss, recoverable range and operational complexity. No patient data required.

Go to the authorisation diagnostic

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 90-day validity from the request date for medical tests, analyses, rehabilitation and psychotherapy. Admissions and interventions require an exact date, and a changed date requires a new request. Clinics should always follow the term shown on the issued authorization.

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 assume which test needs authorization or which term applies without verification. It measures denials, expiries and approved-but-unbilled cases, then holds every proposed action for human approval before submission.

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 90-day validity for medical tests, analyses, rehabilitation and psychotherapy. Admissions and interventions require an exact date and a new request if it changes. Clinics should always check the issued authorization.
What happens if an Adeslas authorization expires?
If the procedure is performed outside the stated term or date, the authorization may no longer cover it. The clinic should review the issued document and resubmit when required. SaludComply prioritizes cases approaching expiry and holds every resubmission for human approval.

Verified sources

Related pages