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Pre-authorisation agent for MetLife

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

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Your health insurerPre-authorisation agentWhatsApp
  1. Customer: I need a knee scope next month. What do I do?
  2. Read the plan’s authorisation rulesMetLife
  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 MetLife

  • Reads the MetLife authorisation rules for the member’s plan and gathers what they need
  • Read a member’s MetLife plan and benefits through the access your team has, such as an API, a file feed or a portal export
  • Answer cover questions from your MetLife plan documents, with the figures for the member’s plan
  • Check a claim’s status and chase the missing invoice, referral or form with the member

Tools.

MetLifeCustomWhatsAppLiveEmailLiveDiscovery HealthLiveVoice and phone callsLive

Questions

What does the pre-authorisation agent do with MetLife?

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

Is the MetLife connector live?

Not yet as a ready-made connector.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide MetLife claims or authorisations?

No.

Are scan results or chats used to price cover?

No.

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

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The pre-authorisation agent with other connectors