Custom, built in days

Claims agent for Epic

The claims agent for Epic fetches the invoice a claim is waiting on from Epic.

Harbour Health CoverClaims agentWhatsApp
  1. Customer: Why do I still owe R640 on this?
  2. Read statement dated 3 OctoberEpic
  3. Claims agent: Your scheme paid R1,560 of the R2,200 specialist bill, at the scheme’s rate. The R640 left is the specialist charging above that rate. You could ask the rooms if they’ll accept the scheme rate.
  4. Customer: Can you ask them?
  5. Claims agent: I can draft the message for you to send, with the claim details. Want it?
Sample conversation. People, brands and figures are made up.

What it can do with Epic

  • Fetches the invoice a claim is waiting on from Epic
  • Read upcoming appointments and the reason for each visit from Epic
  • Write the intake given before the visit into the record, for the clinician to review
  • Attach a call transcript, a scan report or a summary to the right record

Questions

What does the claims agent do with Epic?

Fetches the invoice a claim is waiting on from Epic.

Is the Epic connector live?

Not yet as a ready-made connector.

Does the claims agent change claim outcomes?

No.

Does the agent write into Epic?

Only what you allow: usually intake answers, call summaries and documents, for your clinicians to review.

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.