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Pre-authorisation agent for Strategis Insurance

The pre-authorisation agent for Strategis Insurance 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 rulesStrategis Insurance
  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 Strategis Insurance

  • Reads the Strategis Insurance authorisation rules for the member’s plan and gathers what they need
  • Match the member to their Strategis Insurance option from the 2 on file (Group Health Insurance and Individual Health Cover), with their membership number, from a message or a photo of their card
  • Answer general questions about Strategis Insurance cover, and send plan-specific ones to the Strategis Insurance service line (+255 755 772 111) 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 Strategis Insurance?

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

Is the Strategis Insurance connector live?

Yes.

Does the pre-authorisation agent approve procedures?

No.

Does the agent decide Strategis Insurance 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.