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Pre-authorisation agent for HL7 feeds

The pre-authorisation agent for HL7 feeds collects the quote and codes from HL7 feeds 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 rulesHL7 feeds
  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 HL7 feeds

  • Collects the quote and codes from HL7 feeds for the request
  • Receive admission, discharge and result messages as they happen
  • Start a follow-up call after a discharge message
  • Turn a result message into a plain-language explainer for the person it belongs to

Tools.

HL7 feedsCustomWhatsAppLiveEmailLiveDiscovery HealthLiveVoice and phone callsLive

Questions

What does the pre-authorisation agent do with HL7 feeds?

Collects the quote and codes from HL7 feeds for the request.

Is the HL7 feeds connector live?

Not yet as a ready-made connector.

Does the pre-authorisation agent approve procedures?

No.

Does the agent write into HL7 feeds?

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 HL7 feeds

The pre-authorisation agent with other connectors