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Claims agent for Heritage Health

The claims agent for Heritage Health explains Heritage Health statements line by line and chases missing claim documents.

Ridgeway LogisticsClaims agentWhatsApp
  1. Customer: Why do I still owe R640 on this?
  2. Read statement dated 3 OctoberHeritage Health
  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 Heritage Health

  • Explains Heritage Health statements line by line and chases missing claim documents
  • Match the member to their Heritage Health option from the 8 on file (Camelthorn, Maroela, Hoodia and 5 more), with their membership number, from a message or a photo of their card
  • Answer general questions about Heritage Health cover, and send plan-specific ones to the Heritage Health service line (083 334 2790) 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 claims agent do with Heritage Health?

Explains Heritage Health statements line by line and chases missing claim documents.

Is the Heritage Health connector live?

Yes.

Does the claims agent change claim outcomes?

No.

Does the agent decide Heritage Health claims or authorisations?

No.

Can HR see what staff say to the agent?

No.

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