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Pre-authorisation agent for LA Health

The pre-authorisation agent for LA Health 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 rulesLA Health
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 LA Health

Reads the LA Health authorisation rules for the member’s plan and gathers what they need
Match the member to their LA Health option from the 5 on file (LA Active, LA Focus, LA KeyPlus and 2 more), with their membership number, from a message or a photo of their card
Answer general questions about LA Health cover, and send plan-specific ones to the LA Health 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 LA Health authorisation rules for the member’s plan and gathers what they need.

Yes.

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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.