Anyone who has booked an exam through a health plan knows the sequence: medical order, plan form, authorization. For self-pay exams, part of this paperwork disappears. See what each term means.
Medical order
It is the request written by your doctor, with the exam to be done, the area of the body and often the clinical suspicion. This information guides how the exam is done and how the radiologist analyzes the images.
Plan form (guia)
It is the health plan document that records the exam to be covered by the plan. Each plan has its own form and its own rules.
Authorization
It is the health plan’s approval for the exam to be covered. Some exams, especially the more complex ones, can only be done after it.
What is needed in each case
| Health plan | Self-pay | |
|---|---|---|
| Medical order | Yes | Yes |
| Health plan form | When the plan requires it | No |
| Plan authorization | When the plan requires it | No |
| Health plan card | Yes | No |
| Photo ID and CPF (Brazilian tax ID) | Yes | Yes |
In other words: as a self-pay patient, you need the medical order and an ID document, but you don’t depend on the plan to book. For CT exams through a health plan, the order must be authorized.
Informational content. It does not replace your doctor’s advice.
