Laya Healthcare

Last updated on March 6th, 2019 at 11:12 am

Laya Healthcare

Laya Health Conditions of Payment for PET (Positron Emission Tomography)/PET-CT Scan

The following criteria must be satisfied before your scan will be covered:

General conditions of payment

Benefit is subject to the following conditions of payment which must be satisfied before benefit becomes payable:

  1. The Laya Pre-authorisation form must be completed by the referring consultant
  2. All PET-CT scans must be pre-authorised by Laya Health.
  3. The PET-CT scan is carried out at a PET-CT facility approved by Laya Health for the purposes of providing benefit for our members
  4. The PET-CT scan is carried out for one of the approved clinical indications as listed.
  5. Refer to the General list for PET-CT referral.

Specific conditions of payment

Please refer to the list of approved PET-CT facilities below.

Scan facilities: Approved PET-CT facilitiesHospital TypeCover
Alliance Medical at Cork University HospitalPublicCovered for PET-CT
Beacon Hospital, SandyfordPrivate66% covered for PET-CT
Blackrock Clinic, Co. DublinPrivate
Not covered
The Hermitage Clinic, Lucan
66% covered for PET-CT
Mater Private Hospital, D7
66% covered for PET-CT
St. James Hospital, D8
Covered for PET-CT
Galway Clinic
66% covered for PET-CT
UMPC, Hillman Cancer Centre, Butlerstown
66% covered for PET-CT

N.B: Please ensure that all relevant CT/MRI/Histology reports are attached as Laya will not review any request without relevant clinical data. Laya also require that you include a letter of request, separate to the LAYA form, to perform the PET/CT scan. Please indicate if the patient has undergone any chemotherapy/radiotherapy and if the patient is a diabetic as these can determine when the scan can be done.

Laya will attempt to respond to any request within 24 hours of receipt of correct submission.