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Pre-authorisation agent for Old Mutual Rwanda

The pre-authorisation agent for Old Mutual Rwanda 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 rulesOld Mutual Rwanda
  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 Old Mutual Rwanda

  • Reads the Old Mutual Rwanda authorisation rules for the member’s plan and gathers what they need
  • Match the member to their Old Mutual Rwanda option from the 3 on file (Heza Care, Ishema Care and Health Family Cover), with their membership number, from a message or a photo of their card
  • Answer general questions about Old Mutual Rwanda cover, and send plan-specific ones to the Old Mutual Rwanda service line 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 Old Mutual Rwanda?

Reads the Old Mutual Rwanda authorisation rules for the member’s plan and gathers what they need.

Is the Old Mutual Rwanda connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide Old Mutual Rwanda 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.