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Pre-authorisation agent for Polmed

The pre-authorisation agent for Polmed 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 rulesPolmed
  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 Polmed

  • Reads the Polmed authorisation rules for the member’s plan and gathers what they need
  • Match the member to their Polmed option from the 2 on file (Marine and Aquarium), with their membership number, from a message or a photo of their card
  • Answer general questions about Polmed cover, and send plan-specific ones to the Polmed service line (0860 765 633) rather than guess
  • Read a claims or benefit statement the member sends and explain each line still owed, in plain words

Tools.

PolmedLiveWhatsAppLiveEmailLiveDiscovery HealthLiveVoice and phone callsLive

Questions

What does the pre-authorisation agent do with Polmed?

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

Is the Polmed connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide Polmed 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.

The pre-authorisation agent by vertical

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The pre-authorisation agent with other connectors