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Physician Services / Prior Approvals
Application Form to join the Swagrass network of preferred providers
Jobs
Swagrass Health Care Solutions and Services, LLC
Home
What We Do
F.A.Q
Services
Swagrass Plans
Cards Request
Your health Care Plan!
Find a Guide Service
prior approval
Medical Claim
Hospital Services / Prior Approvals
Pharmacy Services / Prior Approvals
Laboratory Services / Prior Approvals
Radiology Services / Prior Center Approvals
Physiotherapy Services / Prior Approvals
Dentist Services / Prior Approvals
Optical Services / Prior Approvals
Physician Services / Prior Approvals
Application Form to join the Swagrass network of preferred providers
Jobs
physiotherapy services / prior approvals
Dear Physiotherapy
Service
Providers,
Please be aware complete the missing details as in beneficiary card.
Please complete the data missing for
English
Only
.
All attached downloads must be
Original
and
Clear
.
Sincerely!
Select Action Physiotherapy
*
Select Action Physiotherapy
Non-Approval Physiotherapy
Prior Approval Physiotherapy
Service Price Approval Physiotherapy
Governorate
*
Governorate
Alexandria
Cairo
Giza
Qaliubia
Dakhlia
Beheira
Marsa Matrouh
Port Said
Suez
Red Sea
Sharkeya
Qena
North Sinai
South Sinai
Ismailia
Charbia
Menoufia
Menoufia
Fayoum
Domiatta
Benisuef
Minia
Assuit
Souhg
Luxor
Aswan
Area / Branch
*
Number Of Physiotherapy Sessions
*
Number Of Physiotherapy Sessions
1
2
3
4
5
6
7
8
9
10
11
12
Date Of Doctor's Prescription
*
Date Of Doctor's Prescription
Date Of Service
*
Date Of Service
Value Of Physiotherapy
*
Endurance Ratios Of Physiotherapy
*
Endurance Ratios Of Physiotherapy
Nil
5 %
10 %
15 %
20 %
Beneficiary's Card
*
Beneficiary's National ID
*
Physician Prescriptions
*
Swagrass Form
Beneficiary's Phone Number
*
Submit
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You can submit this form only once.
+(203)-4284140
-
Tel
+(203)-4284149
-
Fax
+20-01050057900
-
WhatsApp
info@swagrass.com
6W9R+4QW, Smouha, Alexandria Governorate, Egypt
(Swagrass Health Care Solutions and Services, LLC. Egypt)