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Pre-authorisation agent for Day1 Health

The pre-authorisation agent for Day1 Health gathers what a pre-authorisation needs before a planned procedure.

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Riverside Family ClinicPre-authorisation agentWhatsApp
  1. Customer: I need a knee scope next month. What do I do?
  2. Read the plan’s authorisation rulesDay1 Health
  3. 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?
  4. Customer: I’ll send a photo.
  5. Quote received: codes and hospital foundHealth Loops
  6. Complete request sent to the authorisation team
Sample conversation. People, brands and figures are made up.

What it can do with Day1 Health

  • Reads the Day1 Health authorisation rules for the member’s plan and gathers what they need
  • Match the member to their Day1 Health option from the 3 on file (Day-to-Day, Hospital and Comprehensive), with their membership number, from a message or a photo of their card
  • Answer general questions about Day1 Health cover, and send plan-specific ones to the Day1 Health service line rather than guess
  • Read a claims or benefit statement the member sends and explain each line still owed, in plain words

Tools.

Day1 HealthLiveWhatsAppLiveEmailLiveDiscovery HealthLiveVoice and phone callsLive

Questions

What does the pre-authorisation agent do with Day1 Health?

Reads the Day1 Health authorisation rules for the member’s plan and gathers what they need.

Is the Day1 Health connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide Day1 Health claims or authorisations?

No.

Does the agent triage or diagnose patients?

No.

Ollie’s agents give wellness guidance. They don’t diagnose or prescribe, and hand off to a human expert when needed.

The pre-authorisation agent by vertical

Other agents for Day1 Health

The pre-authorisation agent with other connectors