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Pre-authorisation agent for Namibia Health Plan

The pre-authorisation agent for Namibia Health Plan 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 rulesNamibia Health Plan
  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 Namibia Health Plan

  • Reads the Namibia Health Plan authorisation rules for the member’s plan and gathers what they need
  • Match the member to their Namibia Health Plan option from the 8 on file (Platinum, Titanium, Gold and 5 more), with their membership number, from a message or a photo of their card
  • Answer general questions about Namibia Health Plan cover, and send plan-specific ones to the Namibia Health Plan service line (061 285 5400) 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 Namibia Health Plan?

Reads the Namibia Health Plan authorisation rules for the member’s plan and gathers what they need.

Is the Namibia Health Plan connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide Namibia Health Plan 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.