Start free
Live

Pre-authorisation agent for PSEMAS

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

Start free with this agent
Riverside Family ClinicPre-authorisation agentWhatsApp
  1. Customer: I need a knee scope next month. What do I do?
  2. Read the plan’s authorisation rulesPSEMAS
  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 PSEMAS

  • Reads the PSEMAS authorisation rules for the member’s plan and gathers what they need
  • Match the member to their PSEMAS option from the 2 on file (Standard Option and Higher Option), with their membership number, from a message or a photo of their card
  • Answer general questions about PSEMAS cover, and send plan-specific ones to the PSEMAS service line (061 374 150) rather than guess
  • Read a claims or benefit statement the member sends and explain each line still owed, in plain words

Tools.

PSEMASLiveWhatsAppLiveEmailLiveDiscovery HealthLiveVoice and phone callsLive

Questions

What does the pre-authorisation agent do with PSEMAS?

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

Is the PSEMAS connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide PSEMAS 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

Other agents for PSEMAS

The pre-authorisation agent with other connectors