Live
Pre-authorisation agent for Discovery Health
The pre-authorisation agent for Discovery Health gathers what a pre-authorisation needs before a planned procedure.
Riverside Family ClinicPre-authorisation agentWhatsApp
- Customer: I need a knee scope next month. What do I do?
- Read the plan’s authorisation rulesDiscovery Health
- 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 can do with Discovery Health
- Reads the Discovery Health authorisation rules for the member’s plan and gathers what they need
- Match the member to their Discovery Health option from the 24 on file (Classic Saver, KeyCare Plus, Essential Saver and 21 more), with their membership number, from a message or a photo of their card
- Answer what the member’s option covers from the Discovery Health plan guide, with the figures for their option and the source shown
- Read a claims or benefit statement the member sends and explain each line still owed, in plain words
Questions
What does the pre-authorisation agent do with Discovery Health?
Reads the Discovery Health authorisation rules for the member’s plan and gathers what they need.
Is the Discovery Health connector live?
Yes.
Does the pre-authorisation agent approve procedures?
No.
Does the agent decide Discovery 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.