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Pre-authorisation agent for Essential Med

The pre-authorisation agent for Essential Med 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 rulesEssential Med
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

Sample conversation. People, brands and figures are made up.

What it can do with Essential Med

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

Reads the Essential Med authorisation rules for the member’s plan and gathers what they need.

Yes.

No.

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