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Pre-authorisation agent for GetSavvi

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

Riverside Family ClinicPre-authorisation agentWhatsApp
  1. Customer: I need a knee scope next month. What do I do?
  2. Read the plan’s authorisation rulesGetSavvi
  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 GetSavvi

  • Reads the GetSavvi authorisation rules for the member’s plan and gathers what they need
  • Match the member to their GetSavvi option from the 2 on file (Savvi Care and Savvi Care Plus), with their membership number, from a message or a photo of their card
  • Answer general questions about GetSavvi cover, and send plan-specific ones to the GetSavvi service line rather than guess
  • 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 GetSavvi?

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

Is the GetSavvi connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide GetSavvi 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.