Pre-authorisation agent for health insurers
A ready-made Health Loops agent for health insurers that sends complete pre-authorisation requests to your team.
Harbour Health CoverPre-authorisation agentWhatsApp
- Customer: I need a knee scope next month. What do I do?
- Read the plan’s authorisation rulesBupa
- Pre-authorisation agent: You’ll need authorisation before you’re admitted. Your plan guide asks for the doctor’s quote with the procedure codes and the hospital’s name. Do you have the quote?
- Customer: I’ll send a photo.
- Quote received: codes and hospital foundHealth Loops
- Complete request sent to the authorisation team
What it does with your systems
- Reads the Bupa authorisation rules for the member’s plan and gathers what they need
- Collects documents on WhatsApp, including photos
- Collects documents on Email, including photos
- Reads the Discovery Health authorisation rules for the member’s plan and gathers what they need
Questions
What is a pre-authorisation agent for health insurers?
A ready-made Health Loops agent for health insurers that sends complete pre-authorisation requests to your team.
Does the pre-authorisation agent approve procedures?
No.
What does it ask the member for?
Only what the plan’s rules need, usually the quote, procedure codes, the hospital and the referral.
Are scan results or chats used to price cover?
No.
Ollie’s agents give wellness guidance. They don’t diagnose or prescribe, and hand off to a human expert when needed.