So let’s say you’ve come to Mother and Child Hospital for surgery. You’ve talked to your doctor, your bag is packed, and you’re thinking about how to use your insurance to cover the admission. You’re not alone in that thought. Many patients walk in with the same question –how does the whole process work from start to finish? Let’s take a walk through it together, the way it happens every day at the hospital.

Step 1: Arrival and Registration

You walk up to the reception desk. The staff greets you and asks for your insurance card, ID, and a doctor’s request or referral letter. If you have your doctor’s notes or previous test results, even better. The reception team creates your file and directs you to the insurance desk, where your details are verified with your insurance provider.

Your doctor then reviews you one more time to confirm the need for admission. If surgery is planned, the doctor fills out an admission form and lists the lab tests you’ll need before you go to theatre.

Step 2: Pre-Surgery Tests

Before any surgery, your body has to be checked to make sure it can safely handle anesthesia and recovery. The tests are routine, but very important.
They usually include:

• Full Haemogram: Checks your blood levels and detects infection or anemia.
• HIV, Hepatitis B & C Tests: Help the surgical team plan infection control safely.
• Blood Grouping and Crossmatching: In case a transfusion is needed

Once your results are ready, your doctor reviews them. If everything looks good, you’re cleared for admission.

Step 3: Preauthorization from Insurance

This is the part many patients don’t see, but it’s one of the most important. Before you’re admitted, the hospital sends your insurance provider a preauthorization request. This includes your diagnosis, the reason for admission, the estimated cost of your stay, and the lab results.

The insurer reviews the request and either approves it, asks for more details, or denies it. The time it takes depends on your insurer. Some approvals come within minutes, others may take a few hours. Once approval is granted, the hospital receives an authorization code that allows your admission to proceed.

If your insurer asks for more information, the hospital team follows up immediately to avoid delays. You’re always informed of what’s happening so you know where things stand.

Step 4: Admission and Preparation

With approval in hand, you’re admitted, a file is opened or retrieved if you are not new to the facility as an inpatient, then you are shown to your ward or private room. The nurse explains the admission process, helps you settle in, and prepares you for theatre. You’ll sign a consent form, meet the anesthetist, and get your vitals checked.

At this point, the insurance and billing team is already tracking your approved coverage to make sure all services fall within what your insurer has authorized.

Step 5: The Surgery

The surgical team handles everything with care and precision. You’re monitored throughout the procedure and moved to recovery once it’s done. After that, you’re taken back to the ward where nurses continue to monitor your progress closely.

Step 6: During Admission

Your focus is on recovery. Behind the scenes, the hospital’s insurance team keeps updating your account daily. They monitor medication, nursing care, and any additional procedures. If your doctor extends your stay or recommends another test, the hospital sends a re-authorization/extension request to your insurer for approval.

This coordination ensures your cover remains active throughout your stay and you don’t end up with unnecessary bills.

Step 7: Discharge and Billing

When your doctor confirms you’re fit for discharge, the nurse explains your medication, wound care, and follow-up appointments. Meanwhile, the billing team prepares your final statement.

The insurance office then compiles everything; the admission form, discharge summary, prescriptions, procedure notes, and receipts. This file becomes the insurance claim, which is sent to your insurer for payment.

You’ll be asked to sign the discharge form and clear any co-payments or non-covered services before leaving. For example, some insurance plans don’t cover personal items, certain lab tests, or private room upgrades. The team explains all this clearly so there are no surprises.

Step 8: Claiming from Insurance

Once you’re home, the hospital continues to follow up with your insurer. The claim is reviewed and reimbursed to the hospital after verification. If the insurer needs clarification, the hospital responds with the supporting documents.

For you, the process ends when you’re discharged. The hospital handles the claiming part entirely.

Step 9: Going Home

You leave with your medication, follow-up plan, and your body on the mend. You’ve used your insurance from start to finish without worrying about the paperwork.

Insurance Partners

Mother and Child Hospital works with a wide range of insurance providers to make your admission and treatment process smooth and stress-free.

We currently accept:

• Old Mutual Insurance

• MTIBA–AAR

• MTIBA–GA

• MTIBA–APA

• MTIBA–First Assurance

• MTIBA–Fidelity

• MTIBA (My Health Funds)

• M–TIBA–Jubilee

• Mamatoto / MCH Dada

• Madison Insurance

• First Assurance

• Unisure Group

• Britam Corporate

• Star Discover Insurance

• Heritage Insurance

• Laser Insurance Brokers

• MTN Insurance Agencies

• Insurance for All (IFA)

• MUA Insurance Kenya

• Cigna

• APA Insurance

• Pioneer Insurance

• Kenbright Healthcare Administrators

• Sedgwick Insurance Brokers

• Kenyan Alliance Insurance

• CIC Micro (Afya Bora)

• CIC Insurance Corporate

• MAKL

• AAR Insurance

• Parliamentary Service Commission (Staff Retirement Benefits Scheme)

• LCT Africa

• GA Insurance

• Equity Health Insurance

If your provider is listed, you’re covered for both outpatient and inpatient services. If not, our team will help you confirm or advise on alternative payment options.

Final Note

If you’re planning an admission or surgery, you don’t have to worry about where to start. At Mother and Child Hospital, our insurance and admissions teams walk with you from the first inquiry to the final discharge.

We handle preauthorizations, lab tests, approvals, billing, and claims directly with your insurer so you focus fully on your recovery.

Your health deserves your full attention, not paperwork.

To learn more about how we support insured admissions, visit Mother and Child Hospital in Eastleigh or reach out to our insurance desk. We’ll guide you through the process step by step.

Why This Process Matters

Hospital admissions can feel overwhelming, especially when surgery is involved. But when your hospital understands insurance processes, it makes a huge difference. At Mother and Child Hospital, the insurance and billing teams work hand-in-hand with doctors and nurses to make your experience smooth and clear.

You don’t have to chase approvals, fill confusing forms, or call your insurer every hour. The hospital does all that for you while keeping you informed. Whether it’s a maternity case, a dental surgery, or a specialized procedure, your admission and claim process follow the same transparent steps.

You get care. The hospital handles the process. Your insurer pays for your treatment.

That’s how it works at Mother and Child Hospital – simple, professional, and focused on your recovery.