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Pre-authorisation agent for NHIA Nigeria

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

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Riverside Family ClinicPre-authorisation agentWhatsApp
  1. Customer: I need a knee scope next month. What do I do?
  2. Read the plan’s authorisation rulesNHIA Nigeria
  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 NHIA Nigeria

  • Reads the NHIA Nigeria authorisation rules for the member’s plan and gathers what they need
  • Match the member to their NHIA Nigeria option from the 1 on file (National Health Insurance), with their membership number, from a message or a photo of their card
  • Answer general questions about NHIA Nigeria cover, and send plan-specific ones to the NHIA Nigeria service line rather than guess
  • Read a claims or benefit statement the member sends and explain each line still owed, in plain words

Tools.

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Questions

What does the pre-authorisation agent do with NHIA Nigeria?

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

Is the NHIA Nigeria connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide NHIA Nigeria 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.

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