microsoft/Prior-Authorization-Multi-Agent-Solution-Accelerator

synthesis-decision

Synthesizes outputs from Compliance, Clinical, and Coverage agents into a final APPROVE or PEND recommendation using gate-based evaluation with LENIENT mode policy, weighted confidence scoring, and structured audit trail.

لغة النص الأصلي: الإنجليزية

clinical-review

Extracts clinical data from prior authorization requests, validates ICD-10 diagnosis codes via MCP, notes CPT/HCPCS procedure codes (format validation handled by orchestrator pre-flight), searches supporting literature via PubMed and clinical trials, and…

لغة النص الأصلي: الإنجليزية

coverage-assessment

Verifies provider credentials via NPI MCP, searches Medicare coverage policies via CMS Coverage MCP, and maps clinical evidence to policy criteria with MET/NOT_MET/INSUFFICIENT assessment, per-criterion confidence scoring, and documentation gap analysis.

لغة النص الأصلي: الإنجليزية