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Pre-authorisation agent for FHIR API

The pre-authorisation agent for FHIR API collects the quote and codes from FHIR API for the request.

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Coastline Medical SchemePre-authorisation agentWhatsApp
  1. Customer: I need a knee scope next month. What do I do?
  2. Read the plan’s authorisation rulesFHIR API
  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 FHIR API

  • Collects the quote and codes from FHIR API for the request
  • Read people, appointments and observations from any system with a FHIR API
  • Write a questionnaire response or a document back to the record
  • Start an agent when a new appointment or result appears

Tools.

FHIR APICustomWhatsAppLiveEmailLiveDiscovery HealthLiveVoice and phone callsLive

Questions

What does the pre-authorisation agent do with FHIR API?

Collects the quote and codes from FHIR API for the request.

Is the FHIR API connector live?

Not yet as a ready-made connector.

Does the pre-authorisation agent approve procedures?

No.

Does the agent write into FHIR API?

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

Where do the agent’s answers about benefits come from?

From the scheme’s own published plan guide for the member’s option, and from statements the member sends.

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 FHIR API

The pre-authorisation agent with other connectors